Please help with finding a topic!

[mslema]

I need help coming up with a simple topic or idea for a quality improvement project for a labor and delivery unit. What are some problems on the unit that may affect quality of care? Any suggestions on how it can be improved? Thanks.

[NRSKarenRN, BSN, RN]

http://www.google.com/search?hl=en&rls=GGLF,GGLF:2005-31,GGLF:en&sa=X&oi=spell&resnum=1&ct=result&cd=1&q=quality+improvement+%2B+labor+and+delivery&spell=1

[Daytonite, BSN, RN]

Any quality improvement project follows--surprise!--the nursing process! The steps of the nursing process are:

1. Assessment
   
2. Determine Problem
   
3. Planning (developing goals and interventions)
   
4. Implementation
   
5. Evaluation

In quality improvement projects you assess using policies and procedures, safety guidelines and other things such as state laws regarding building safety, etc. Take a walk around the L&D unit and look at every nook and cranny and think about what you are seeing. Sit in a quiet corner and silently watch the staff as they are going about their work. Does anything stick out as needing correction or improvement? If it is nursing related, go to the policy and procedure manual and see if there is a policy or procedure on the subject. That is your first guideline to use to assess the problem. Is the policy and procedure being followed? To know for sure you need to do a formal assessment. You develop a tool (usually a questionnaire) that addresses what the policy and procedure manual states and then perform an assessment of the staff to get empirical data to prove you've got a problem. That data will bring you to the second step of the nursing process--determining the problem. Moving on to the planning stage, step #3, you decide what goals and interventions you are going to perform. Your goal will be important as will your interventions because you want to move the staff toward some new behaviors usually. Many times this involves inservicing. That would be part of the implementation phase. In the evaluation phase, step #5, you would re-evaluate using that tool you originally developed back in the first step to see if your interventions have made any change and difference in the new data you collect. Is there improvement, or not?

Make sense? I was on QA committees for a number of years and this is the way it is done. Our assessment tools for nursing procedures were basically the steps of the procedures as they were listed in the manual and we would just check off whether or not each nurse was doing each step as we watched them perform the procedure. The same was done for following policies as well (things like documentation, following standing orders, etc.).