Create an abstract (100-250 words) and a poster for a presentation with voice-over for a quality improvement plan to executive-level leadership.

• Create an abstract (100-250 words) and a poster for a presentation with voice-over for a quality improvement plan to executive-level leadership.
  Introduction
• TOPIC- DIABETES MELLITUS
  Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.
  As a master’s-level nurse you will be responsible for promoting equitable quality of care. In the biopsychosocial model of care, there are a number of areas where you can have an impact on improving the quality, safety, and equitability of care. One example area where equitable quality of care is an issue is with medications, especially considering the cost of various medications to treat the same condition versus the effectiveness and potential side-effects of the medications. A further pharmacological concern for safe and quality care is medication errors. This could include considerations like a patient getting the wrong medication or a dangerous interaction due to other aspects of a patient’s health and treatment situation. An example could be vitamin or herbal supplements the patient has not disclosed as part of the medication reconciliation process.
  The ability to propose and promote quality improvements in care is a vital skill for a master’s-prepared nurse. One aspect of this is understanding strategies for implementing best practice changes in a team, department, or care setting. Another is understanding how best practices can help lead to a continuous quality improvement cycle. Additionally, it is important to grasp how successful change strategies can be leveraged to help in the creation or implementation of clinical best practices. Part of this is considering the audience when proposing quality improvement projects or new best practices. Another part of this is being able to effectively communicate the goals, rationale, and benefits of a project.
  One way to communicate the need for quality improvements, and your plans for achieving specific improvements, is through a presentation poster. This type of communication tool is used both in the work place and at professional and academic conferences. Being able to convey the essence and value of a project in a compelling and succinct way is a valuable skill, and it is vital within the constraints of a single poster.
  Professional Context
  As a master’s-level nurse, you will be responsible for promoting equitable quality of care. In the biopsychosocial (BPS) model of care, there are a number of areas where you can have an impact on improving the quality, safety, and equitability of care. One example area where equitable quality of care is an issue is with medications, especially considering the cost of various medications to treat the same condition versus the effectiveness and potential side-effects of the medications. A further pharmacological concern for safe and quality care is medication errors. This could include considerations like a patient getting the wrong medication or a dangerous interaction due to other aspects of a patient’s health and treatment situation. An example could be vitamin or herbal supplements the patient has not disclosed as part of the medication reconciliation process.
  Scenario
  For this assessment, you may take any number of approaches. Two suggestions are:

  Build upon the clinical issue that was the focus of your Change Strategy and Implementation assessment, and turn it into a full, organization- or community-wide quality improvement (QI) initiative.
  Or, identify a new issue related to a BPS clinical issue. The focus here should be on a specific patient or health care setting
  As a master’s-level nurse, your specific focus is on reviewing the implications of the data relevant to the clinical issue you are trying to address. Once you research this, review the aggregate data, and understand the BPS considerations relevant to the clinical issue, you can suggest strategies for improving the quality, equitability, and safety of care around the issue. You should act as an advocate for the value and need to pursue quality improvements to leadership and executives, as well as be able to present potential projects to a wide range of colleagues and community stakeholders.
  Instructions
  Create an abstract and a poster for a presentation with voice-over to your colleagues that will sell them on your quality improvement plan.
  Abstract Requirements
  Your abstract should be 100–250 words.
  It should summarize the key information in your poster.
  Do not put your abstract on the poster itself; submit it as a separate document. Or, if you are using PowerPoint to help create your poster, create a new slide that is clearly labeled as your abstract.
  Poster Requirements
  Your poster should include the following sections: 

  Quality Improvement Methods.
  Evidence Supporting QI Methods.
  Change Strategy Foundation.
  Interprofessional Team Benefits.
  Overall Project Benefits.

  There are templates in PowerPoint or on the Internet that can help you get a start designing your poster.
  The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your presentation addresses all of the bullets below. You may also want to read the Quality Improvement Presentation Poster scoring guide and Guiding Questions: Quality Improvement Presentation Poster [DOCX] to better understand how each grading criterion will be assessed.
  Propose quality improvement methods to promote continuous improvement related to a specific biopsychosocial consideration.
  Evaluate specific evidence that supports the quality improvement methods proposed.
  Explain how the project is grounded in successful change strategies.
  Analyze the way in which interprofessional teamwork will improve the effectiveness or efficiency of the quality improvement project.
  Communicate quality improvement considerations to relevant stakeholders in a way that is clear, concise, and compelling for the audience.
  Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
  Example assessment: You may use the assessment example, Assessment 3 Example [PPTX], to give you an idea of what a Proficient or higher rating on the scoring guide would look like.
  Submission Requirements
  Length of submission:

  Abstract: 100–250 words. Your abstract should be succinct and precise.
  Poster: Make sure your poster fits entirely onto a single poster template page (or slide) and contains all of the sections described in the assessment instructions.

  Number of references: Cite a minimum of 5–7 sources of scholarly or professional evidence that support your considerations and plans. Resources should be no more than five years old.
  APA formatting: Resources and citations are formatted according to current APA style.
  Competencies Measured
  By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
  Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes. 

  Evaluate specific evidence that supports the quality improvement methods proposed.

  Competency 2: Develop change strategies for improving the care environment. 

  Explain how the project is grounded in successful change strategies.

  Competency 3: Apply quality improvement methods to practice that promote safe, equitable quality of care. 

  Propose quality improvement methods to promote continuous improvement related to a specific biopsychosocial consideration.

  Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes. 

  Analyze the way in which interprofessional teamwork will improve the effectiveness or efficiency of the quality improvement project.

  Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards. 

  Poster is presented in a way that is clear, concise, and compelling for the audience.
  Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Learner’s Name
Capella University
Biopsychosocial Concepts for Advanced Nursing Practice I
Quality Improvement Presentation: Title
Abstract

The underdiagnosis and the undertreatment of comorbidities of chronic obstructive pulmonary disorder (COPD) such as anxiety and depression are key issues in pulmonary care. Typically, primary care involves addressing physical health issues, such as COPD, which have a significant impact on patients. However, this does not adequately account for the overall well-being of patients. Anxiety and depression may have negative impact on patients’ quality of life and are likely to impede their ability to recover (Pooler & Beech, 2014). To address this, it is necessary to provide patients with access to mental health facilities. The change strategy proposed in this presentation is to provide cognitive behavior therapy (CBT) to patients by mental health professionals. Organizations could also train their nurses in CBT or hire nurses who are trained in CBT. The Deming Cycle, or the Plan-Do-Check-Act (PDCA) cycle, could be used to evaluate the efficacy of the strategy. The PDCA cycle would ensure that the change strategy is adequately evaluated in terms of whether it improves patients’ quality of life and their ability to cope both mentally and physically with COPD, anxiety, and depression.

Quality Improvement Presentation: Title of Poster
Learner’s Name
Capella University
Biopsychosocial Concepts for Advanced Nursing Practice I
Date
Quality Improvement Methods
The PDCA cycle is one of the tools used in quality improvement (Pietrzak & Paliszkiewicz, 2015).
Once an area of improvement is identified, it is necessary to provide a plan of action to enhance the outcomes in that area.
The plan of action would address the issue of insufficient care by providing COPD patients with adequate access to mental health facilities.
The next step is implementation. This is the “do” stage of the Deming Cycle. During this stage, it is necessary to execute the plan on a small scale to record its results and evaluate its efficacy.
The effects of the change implemented are then evaluated during the “check” stage of the PDCA cycle (Pietrzak & Paliszkiewicz, 2015). The key question to be asked at this stage is whether the change does what it purports to do. If it does, would the change positively affect patients’ recovery and capacity to self-manage their condition?
Based on the evaluation during the “check” stage, the quality improvement method is modified, and the cycle is repeated if the implemented change does not match the expected outcome. If the change proves to be effective, the quality improvement method is standardized and documented (Pietrzak & Paliszkiewicz, 2015).
Evidence Supporting QI Methods
In health care, quality improvement comprises continuous, combined efforts by patients, professionals, researchers, and institutes to improve processes toward better patient care, health care outcomes, and professional development (Carvalho et al., 2017).
The PDCA cycle is a useful tool as it focuses on the creation of a plan followed by its execution and the evaluation of its results. By following this process, organizations can identify and rectify the shortcomings of the assumptions that their change strategies are based on.
The PDCA cycle provides a structure for teams to initiate change from within the system. The framework of the PDCA cycle ensures that the objective of any change process is within sight at all times and that the improvement that a process achieves is visible (Donnelly & Kirk, 2015).
Change Strategy Foundation
Overall Project Benefits
The change strategy proposed here would involve teams of physicians, nurses, and mental health professionals.
Teams would work together to coordinate the patient’s treatment. This would require consistent communication and cooperation between teams.
Through an interprofessional collaboration, the teams would identify gaps in patient safety and improve coordination in implementing change strategies (Amalakuhan & Adams, 2015).
Patients who suffer from COPD are often comorbid with anxiety and depression. These conditions can impede their recovery (Pooler & Beech, 2014). Shortness of breath is a symptom common to both COPD and anxiety and can be distressing for the patient. A COPD patient who also presents with anxiety might interpret SOB in an exaggerated manner, associating it with an inability to breathe or imminent death (Heslop et al., 2013).
If a COPD patient’s anxiety or depression is left untreated, it can significantly impact compliance with COPD treatment. Anxiety and depression can affect a patient’s cognitive functioning and their ability to self-manage the condition (Pooler & Beech, 2014).
COPD patients who received treatment for anxiety and depression coped with physical and mental conditions much better than patients who do not receive treatment (Howeard & Dupont, 2014).

Interprofessional Team Benefits
Evidence from studies cited here indicates an interprofessional approach that caters to COPD patients’ physical and psychological needs would improve their quality of life and aid their ability to self-manage and thereby recover from both issues.
Using the Deming Cycle, physicians, nurses, and mental health professionals could evaluate the outcomes of implementing a CBT program for COPD patients.
By ensuring that quality improvement is an ongoing process, patients will receive care that is continuous and of high quality, and teams will be able to develop better communication and cooperation among themselves.
Through a collaborative approach, physicians, nurses, and mental health professionals could identify gaps in patient safety during the implementation of change strategies.

Limitations of the PDCA Cycle
The PDCA cycle itself cannot guarantee quality improvement. The process of achieving a solution is slow and may not be linear. The cycle focuses on learning and taking informed actions. Adapting the cycle to different problems may not be simple and may require extensive skills and knowledge (Reed & Card, 2015).
Insufficient planning may lead to failure in achieving desired results (Reed & Card, 2015).
Strategies of the PDCA cycle also require scenarios that are not necessarily realistic (Pietrzak & Paliszkiewicz, 2015). When applied to realistic scenarios, these strategies could lead to failure, thereby creating more problems or adding to existing ones.
To arrive at a solution to a problem, the four-step process has to be repeated several times. An iterative process could result in slow progress (Kliem, 2015). Therefore, the cycle may be ineffective at achieving swift results in emergencies (Reed & Card, 2015).
Knowledge Gaps and Unknowns
If data received from the check phase is misinterpreted, people may arrive at inaccurate conclusions, leading to incorrect actions (Reed & Card, 2015).
When the PDCA Cycle is applied before a clinical intervention is fully implemented, the focus of the improvement process is likely to shift (Coury et al., 2017).
It was observed that several clinicians commonly found it challenging to measure the success of the PDCA cycle using the electronic medical record tools available (Coury et al., 2017).
The cycle also focuses on observing and rectifying errors. It does not predict errors.
Potential Challenges
COPD patients require access to therapists trained in CBT. It might be difficult to conduct one-on-one sessions for every patient; therefore, organizations could train their nurses in CBT or hire nurses who are trained in CBT.
Helping COPD patients achieve sustainable improvement in quality of life, functioning, and general physical condition can be challenging. Group therapy sessions can help patients talk about and cope with both physical and psychological issues. Providing COPD patients with access to CBT along with their regular treatments is likely to improve their quality of life and capacity to self-manage their condition (Pietrzak & Paliszkiewicz, 2015; Pooler & Beech, 2014).

2

Quality Improvement Presentation Poster
Learner’s Name
Capella University
Biopsychosocial Concepts for Advanced Nursing Practice I
Quality Improvement Presentation
References
April, 2019
Amalakuhan, B., & Adams, S. G. (2015). Improving outcomes in chronic obstructive pulmonary disease: The role of the interprofessional approach. International Journal of Chronic Obstructive Pulmonary Disease, 10(1). 1225–1232.

Carvalho, F., Jun, G. T., & Mitchell, V. (2017). Participatory design for behaviour change: An integrative approach to healthcare quality improvement. Paper presented at IASDR 2017 Proceedings, 7th International Congress of the International Association of Societies of Design Research, Cincinnati, OH.

Coury, J., Schneider, J. L., Rivelli, J. S., Petrik, A. F., Seibel, E., D’Agostini, B., . . . Coronado, G. D. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC Health Services Research, 17(411).

Donnelly, P., & Kirk, P. (2015). Use the PDSA model for effective change management. Education for Primary Care, 26(4), 279–281.

Heslop, K., Newton, J., Baker, C., Burns, G., Carrick-Sen, D., & De Soyza, A. (2013). Effectiveness of cognitive behavioural therapy (CBT) interventions for anxiety in patients with chronic obstructive pulmonary disease (COPD) undertaken by respiratory nurses: The COPD CBT CARE study: (ISRCTN55206395). BMC Pulmonary Medicine, 13(1).

Howard, C., & Dupont, S. (2014). ‘The COPD breathlessness manual’: A randomised controlled trial to test a cognitive-behavioural manual versus information booklets on health service use, mood and health status, in patients with chronic obstructive pulmonary disease. npj Primary Care Respiratory Medicine, 24.

Kliem, R. L. (2015). Managing Lean Projects. Boca Raton, FL: CRC Press.

Pietrzak, M., & Paliszkiewicz, J. (2015). Framework of strategic learning: The PDCA cycle. Management, 10(2), 149–161.

Pooler, A., & Beech, R. (2014). Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: A systematic review. International Journal of Chronic Obstructive Pulmonary Disease, 9(1), 315–330.

Reed, J. E., & Card, A. J. (2015). The problem with Plan-Do-Study-Act cycles. BMJ Quality & Safety, 25(3), 147–52.

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Abstract

Quality improvement methods are vital in treating biopsychosocial conditions. Diabetes is a chronic disease that requires follow-
up care to prevent comorbidities. With an increased population suffering from diabetes, mainly type 2 diabetes, traditional
treatments are ineffective, and a new treatment approach should be adopted. While this is deemed a plausible solution to curb the
increase of diabetes, research indicates that 70% of quality improvement initiatives fail within twelve months of implementation
(O’Donoghue et al., 2021). Therefore, stakeholders must follow proposed improvements methods closely to achieve meaningful
and sustainable change. To combat widespread chronic diseases such as diabetes, strategies such as self-management support,
intensified treatment, encouraged physical activity, and patient education plays a crucial role in managing a patient’s condition.
The disease heavily relies on one self-management abilities. The proposed strategies aim to achieve patient adherence to prevent
other health effects that can be otherwise be contained and ensure that mental distress often experienced by diabetes patients is
adequately dealt with.

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Quality Improvement Presentation Poster
Yudelca Collado

Capella University
Biopsychosocial Concepts for Advanced Nursing Practice I

Quality Improvement Presentation Poster
1/27/2022

Quality Improvement Methods

• The word “quality improvement” refers to the practice of enhancing
the intended outputs of an existing process. Typically, this would need
previous knowledge of the process and the areas that may be
improved.

• Once a problem has been identified, it is critical to develop a plan of
action to improve the outcomes in that area. Recent studies have
indicated the sufficient evidence-to-clinical practice gap in diabetes
care (Mukerji et al., 2019). Upon discovering this, several plans of
action are required to improve the gaps in care delivery towards
diabetes patients.

• While most providers concentrate on the physical aspect of the
patient’s health, research indicates that diabetes patients are often
affected by depression and diabetes distress ( Gary et al., 2019). This
results in underdiagnosis and undertreatment of diabetes patients,
which impedes patients’ chances of managing their health condition.

• With the identification of this, challenges within primary care must be
addressed to ensure that there is sufficient screening for both
depression and diabetes distress.

• Several strategies must be applied to sufficiently monitor the patient:
self-management support, intensified treatment, encouraged physical
activity, and patient education.

• To prevent overwhelming the patient and the provider in charge, the
changes must be implemented on small, scalable stages whereby the
efficiency is measured and evaluated at each stage.

• During these stages, the quality improvement methods are evaluated
to ensure that their objectives are met and analyzed to identify any
positive or negative impacts on the patient recovery progress.

• The strategies can be modified and improved upon observed
evaluation to achieve desired results.

• The change strategy proposed would involve physicians, nurses,
certified diabetes educators, nutritionists, and mental health
professionals.

• These teams would coordinate the patient’s treatment plan based on
evidence-based best practices.

• Through an interprofessional collaboration, the teams would identify
effective strategies to manage diabetes and self-care.

Evidence Supporting QI Methods

• Self-Management support. Patients with type 2 diabetes are often
likely to have poor adherence to glucose level medication,
cholesterol, and blood sugar (Gary et al., 2019). Self-care is critical
in diabetes patients in the reduction of disease complications. Self-
care behaviors involve proper nutrition, regular glucose monitoring,
daily exercise, and adequate medication.

• Intensified treatment. Limited training on handling diabetes patients
has played a vital role in treating patients suffering from the disease.
Studies have shown that 50% of patients with diabetes remain
unscreened for depression (Gary et al., 2019). Having identified
this, healthcare providers are encouraged to conduct complete
health assessments to diagnose the patient thoroughly.

• This will involve the deployment of specialist health personnel in
healthcare facilities to ensure that patients’ mental health is screened
regularly to accurately distinguish symptoms of depression or
diabetic distress from signs of physical illness.

• Stress management. Regular physical exercise is vital for diabetes
patients to control their glycemic levels. This lowers the chances of
depression which is significantly increased due to lower physical
activity ( Williams et al., 2016).

• Education. Patients need to be educated on how to manage their
diabetic conditions, read their glycemic levels, and seek social
support systems. Training camps for health personnel should be
implemented to ensure that physicians are sufficiently able to
diagnose depression diabetes distress, re-evaluate patients’
conditions and apply the effective treatment (O’Donoghue et al.,
2021).

Kent, B. (2019).
Implementing research findings into practice
. International Journal of Evidence-Based
Healthcare, 17, S18-S21.

Mukerji, G., Halperin, I., Segal, P., Sutton, L., Wong, R.,
Caplan, L., … & Gilmour, J. A. (2019). Beginning a
diabetes quality improvement project. Canadian
journal of diabetes, 43(4), 234-240.

O’Donoghue, S. C., DiLibero, J. & Altman, M. (2021).
Leading sustainable quality improvement. Nursing
Management (Springhouse), 52(2), 42-50.

Owens-Gary MD, Zhang X, Jawanda S. The importance
of addressing depression and diabetes distress in
adults with type 2 diabetes. J Gen Intern Med.
2019;34(2):320-324.
https://doi.org/10.1007/s11606-018-4705-2

Taylor, J. (2016). Continuous improvement in clinical care
. British Journal of Nursing, 25(18), S41.

Williams, J.S., Winchester R.J., & Wolfman T.E.
Depressive symptoms, serious
psychological distress, diabetes distress and
cardiovascular risk factor control in patients
with type 2 diabetes. J Diabetes
Complications. 2016; 30: 312-317

Quality improvement

Potential Challenges

• Achieving sustainable outcomes in Quality Improvement programs
is always challenging. To achieve positive changes educating staff
on implementing the changes and enforcing their adherence is vital.

• Based on the complexity that health personnel encounter in terms
of human aspects of change which creates resistance amongst
patients during a cultural shift in the health sector (Gary et al.,
2019).

• Effective communication should be applied across all stakeholders
to ensure the success of the strategies to ease compliance with the
new measures.

References

Evidence presented by recent studies shows that early and proper
screening can effectively prevent and treat depression and diabetes
distress which results in improved diabetes self-management and
quality of life amongst patients living with type 2 diabetes (Williams et
al., 2016).

Inter-professional teams

Overall Project Benefits

If the recommended quality improvement technique provides ideal
results, the procedure might be standardized.

By making quality improvement a continuous process, patients will
get consistent, high-quality care, and teams will be able to increase
communication and cooperation.

Working collaboratively, physicians, nurses, and mental health experts
may be able to identify gaps in patient safety throughout the
implementation of change approaches.

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