NURS FPX 6016 Assessment 3 Quality Improvement Initiative

NURS FPX 6016 Assessment 3 Quality Improvement Initiative Evaluation

 

Student name

Capella University

NURS-FPX6016 Quality Improvement of Interprofessional Care

Professor Name

Submission Date

Slide 1

• Quality Improvement Initiative Evaluation

Good morning, everyone. My name is ________. My presentation is known as Insulin Safety Prediction and Interprofessional Collaboration. The proposal will achieve the objectives of creating an evidence-based quality improvement initiative that will help to improve the safety of insulin administration and aid in the minimization of the number of cases of hypoglycemia among hospitalized patients in the St. Marys Medical Center.

Slide 2

One of the near-miss incidents at St. Mary’s Medical Center identified a lack of communication during the handoff process, verification, and interdisciplinary coordination (St. Mary’s Medical Center, 2025). Insulin administration error is one of the most prevalent and possibly hazardous medication errors in medical care, which most often leads to serious hypoglycemia and long-term hospital stay. Despite all these safety measures being introduced with the help of the implementation of the concept of having double-check systems, electronic alerts, workflow interruptions, alert fatigue, and the lack of regular communication, they still pose a challenge to the effective management of insulin (McKay et al., 2022).

The purpose of this presentation is to examine the dashboard information on insulin safety, identify the areas requiring improvement, and propose a predictive and interprofessional quality improvement model. Improving medication safety, relying on technology-based risk evaluation, enhancing interprofessional collaboration, and improving patient outcomes through a reduction of insulin-related adverse events are the most significant objectives.

Slide 3

• Data Analysis and Healthcare Issue Identification

The analysis of the dashboard data of the St. Mary Medical Center showed that the situation with insulin safety improved considerably after the implementation of the Smart Insulin Safety Protocol (SISP). In the initial six months, the number of insulin-related errors decreased approximately 35-50 times, and compliance with the verification of both checks increased 95 times (MacLeod & Vigersky, 2022).

• Insulin Safety Gaps

However, the statistics also demonstrate that some of the gaps remain to be addressed, including the variation between day and night shifts, overridden sleep alerts in the electronic health record (EHR), and slow glucose documentation. All this shows that despite this improvement, the current system can still be prone to inefficiency in operations and human error.

The facility performance is higher than the possible limits in terms of such national requirements as NPSG 03.05.01 of the Joint Commission, which targets the elimination of high-ranked medication-related harm, and AHRQ patient safety indicators (Dager et al., 2020).

Under the national quality forum (NQF) standards, the number of near-misses is expected to be less than six per 1,000 patient days, but currently, the facility is in the range between 8 and 10. These results indicate that the necessity of developing more effective predictive analytics should cause the improvement of alert management and interprofessional control to mitigate the risks of insulin administration to achieve the national safety objectives.

• Quality of Data

The mentioned data that have been utilized to complete this quality improvement analysis are valid data and are aligned to the national quality indicators of insulin administration safety, although there is a certain amount of limitations that can affect completeness and the scope of the data. The fact that the decrease in hypoglycemia and cases of near miss is recorded does not imply that the performance is evaluated in a comprehensive way because there are no specific measures, such as the rate of alert override, compliance rates among staff members on a shift basis, and patient outcomes (Reddy et al., 2020).

Moreover, dissimilarities in data entry actions and variation in records in nursing units may reduce aggregate accuracy. In order to resolve these problems, St. Mary Medical Center may consider applying predictive analytics, a standardized reporting format, and workflow mapping to gain a clearer insight into how the insulin safety system performs, and to increase the level of trustworthiness of the data to be used in decision-making.

Slide 4

• Quality Improvement Initiative Proposal

The proposed project is known as Smart Insulin Safety Protocol 2.0 (SISP 2.0), which is an EHR-based hypoglycemia risk score to predict high-risk patients prior to insulin administration to implement proactive dose or monitoring modifications (Rosen et al., 2021).

A pharmacist-nurse co-verification system of accountability will be implemented in order to provide real-time medication monitoring and accountability. The program is also aimed at simplifying and prioritizing EHR alerts to reduce fatigue caused by alarms and react more quickly. With the help of these evidence-based approaches, SISP 2.0 will help to minimize adverse events related to insulin, improve the workflow, and increase safer medication practices among the medical staff of St. Mary’s Medical Center.

• Quality Improvement Challenges

Although the available quality measures, including The Joint Commission National Patient Safety Goal (NPSG 03.05.01) and AHRQ patient safety indicators, target minimization of medication-related harm, they are not effective enough to tackle the particular issues of insulin administration errors in St. Mary. The current performance of the facility is above the allowable levels; however, the number of near-misses is still larger than the less than 7.8 and 31.9 per 1,000 patient days established by the National Quality Forum (NQF) (Isaksson et al., 2021).

This shows that there are specific areas that should be improved. Through the SISP 2.0 project, the mentioned gaps will be addressed by addressing shift-based performance differences, the rate of alert overrides, and the rate of glucose recording. The initiative will also help to improve patient safety outcomes and medication errors by deploying real-time monitoring and predictive tools.

The main issue of achieving these quality improvement metrics is the obstruction of organizational and systemic barriers, such as the incorporation of new technologies and compliance of the staff with updated procedures. The presence of differences in performance between shifts and departments and the need to coordinate interdisciplinary teams make it possible that progress can be stalled.

Also, it takes a major cultural and operational adjustment in the healthcare environment to guarantee consistency in data input and reduce alert fatigue. These obstacles should be addressed with the help of extensive training and feedback systems, and the high priority of collaboration among all healthcare professionals who are involved in the process of insulin administration in St. Mary’s Medical Center.

Slide 5

• Knowledge Gaps

The evaluation of the Smart Insulin Safety Protocol is still lagging behind in terms of knowledge gaps. The most significant missing data are the workflow timing information that could define the bottlenecks in medication administration, low-quality feedback that night-shift staff members often have to provide, as they usually face a larger workload, and the frequency of EHR alert overrides (Mahran et al., 2025).

The uncertainties will be countered by focusing on the data collection, questionnaires of the employees, and system checks, which will create a satisfactory perception to simplify the protocol and bring about a consistent improvement of the insulin safety procedures.

Slide 6

• Interprofessional Collaboration and Actions

The active involvement of the interprofessional team, in which the members have clearly defined roles, is the key to the implementation of SISP 2.0 in St. Mary’s Medical Center. The actual insulin orders check will be performed by pharmacists to ensure accuracy and eliminate the vice, and the actual insulin administration will be done by the nurses who will make sure that the insulin levels are checked with a second licensed nurse and that the insulin dose is correct (Moustafa et al., 2025).

The IT department will streamline the EHR alert systems to reduce the false alarms and maximize the usability, and the leadership will ensure that the policies are followed, adequate staffing, and an accountability culture within the organization. The communication, feedback, and shared learning will be done in teams and interdisciplinary meetings, which will contribute to improving the principles of teamwork and continuous improvement in patient safety.

• Interprofessional Team Engagement

To guarantee the maximum level of engagement, it will be necessary to conduct thorough training, communicate the roles of each of the team members, and allow them to receive feedback regularly. The roles of each professional should be identified as a major part of the success of the initiative, and an attempt should be made to ensure that all positions are actively engaged in the decision-making process.

The non-nursing ideas of predictive analytics, systems engineering, and workflow optimization will be included in the initiative, which will necessitate the contribution of IT specialists and process improvement experts to make the insulin safety system a seamless and efficient system.

Results that will be used to assess the effectiveness of this initiative, including a decrease in insulin errors, increased adherence to safety measures, and a decrease in the time of alert response, will have a profound effect on the interprofessional team. These quantifiable outcomes will give proper feedback about the effectiveness of the intervention and further improvements.

It is projected that the suggested program will enhance the quality of work-life of the nursing personnel and the wider healthcare team by offering a chance to decrease the frequency of insulin-related errors or alert fatigue, enhance efficiency in the workflow, and provide a more supportive and collaborative climate (Moustafa et al., 2025). SISP 2.0 will not only increase patient safety but will facilitate a more pleasant, less stressful work experience for all concerned since it presents a more structured accountability and shared responsibility system.

Slide 7

• Assumptions

The suggested project of SISP 2.0 presupposes the accuracy, consistency, and stability of the information that the dashboards of the facility analyze, and its genuine reflection of the clinical performance. It also assumes that it will offer the employees sufficient training, management and resources to launch the new predictive tools and verification systems.

It is also based on the assumption that the interprofessional teams will be functioning efficiently, and the organizational culture will be amenable to the open reporting of the near-misses. The assumptions are critical to the project and the success of the project in the long-run, and have a direct impact on the project in terms of whether the project can lead to quantitative improvements in terms of insulin safety and patient outcomes.

Slide 8

• Collaboration Strategies for QI Success

The success of the SISP 2.0 initiative in St. Marys medical center depends on effective communication strategies. The tools of formal communication, like SBAR and shared EHR dashboards, will promote transparency and provide the information in a timely manner in the process of insulin administration. SBAR will ensure the consecutive flow of essential information between nurses, pharmacists, and physicians, whereas EHR dashboards will enable tracking the insulin administration in real-time, which will decrease the number of potential mistakes and enhance the decision-making process.

Frequent safety huddles, feedback, and intercultural audits allow a person to engage in the lifelong learning process and help to identify the barriers to the working process in their early stages (Pimentel et al., 2021). The creation of a culture of psychological safety will enable the staff to report near misses without fear of blaming and will result in higher levels of shared responsibility and compliance in general. All the above strategies facilitate participation, cooperation, and quality enhancement, leading to the long-term outcome.

• Team Communication Strategies

Along with written communication, verbal and face-to-face communication will also be crucial to team bonding and solving any issues. Daily or weekly safety huddles will provide the team with an opportunity to discuss critical changes, problems, and achievements (Pimentel et al., 2021).

Moreover, the communication and collaboration within the team can be evaluated and enhanced with the help of intercultural audits, and diverse opinions are taken into account. Open dialogue will be promoted by the creation of a culture of psychological safety so that the staff feel free to report near-misses without fear of blame and to promote shared responsibility and compliance throughout the team.

To ensure more success in the SISP 2.0 initiative, models of communication like CUS (Concerned-Uncomfortable-Safety issue) would be added. The CUS model enables the staff to bring up patient safety-related concerns within a short time frame so that the critical issues can be addressed in a timely and sufficient manner (Agency for Healthcare Research and Quality, 2023).

This and the application of SBAR, as well as the feedback loop, will facilitate a safety and accountability culture in which every member of the team is on the same track and geared towards similar objectives, which will eventually enhance patient safety and quality of insulin administration at St. Marys Medical Center.

Slide 9

• Assumptions

The provided SISP 2.0 project is supposed to implement patient safety and workflow improvement, which can be measured (Stefan et al., 2024). The objectives that are to be attained in six months are a reduction of fifty percent in the number of incidences of hypoglycemia, ninety-five percent of the patients checking their glucose levels prior to insulin, and the number of EHR warning messages should be cut by thirty percent. By following the results in real-time, dashboard indicators will be utilized in monitoring the progress and where to concentrate.

This program presupposes that the data collection process will be adequate and on time, the staff number will be sufficient, and the corresponding working team will be trained and engaged. Long-term interprofessional contribution and leadership encouragement also presuppose the success of this quality improvement endeavor that can be scaled in the long-term perspective.

Slide 10

• Conclusion

To sum up, the Smart Insulin Safety Protocol 2.0 (SISP 2.0) is a step toward the right direction of decreasing the count of insulin administration errors with the assistance of predictive analytics, collaboration among professionals, and continuous quality improvement. The commitment of such a venture will help avoid and reduce the levels of hypoglycemia and increase the compliance of the staff, along with the environment, which will be safer due to the assistance of real-time data and evidence-based actions.

The use of teamwork together with technology is a guarantee that the decisions made in the clinical setting are evidence-based, effective and patient-centered. It should be the case in the future that all interested parties are devoted to maintaining the improvements, enhancing the working processes, and developing the culture of learning and accountability to guarantee further excellence in medication safety.

Explore NURS FPX 6016 Assessment 3 Quality Improvement Initiative and master strategies to enhance healthcare outcomes today!

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References for NURS FPX 6016 Assessment 3

Agency for Healthcare Research and Quality. (2023, May). Www.ahrq.gov. https://www.ahrq.gov/teamstepps-program/curriculum/mutual/tools/cus.html

The Joint Commission Journal on Quality and Patient Safety, 46(3), 173–180. https://doi.org/10.1016/j.jcjq.2019.12.004

Monitoring preventable adverse events and near misses. Journal of Patient Safety, 18(4), 325–330. https://doi.org/10.1097/pts.0000000000000921

MacLeod, J., & Vigersky, R. A. (2022). A review of precision insulin management with smart insulin pens: Opening up the digital door to people on insulin injection therapy. Journal of Diabetes Science and Technology, 17(2). https://doi.org/10.1177/19322968221134546

Mahran, G. S. K., Abu Aqoulah, E. A., Seleem, E. A. E. S., Hawash, M. A. E., & Ahmed, R. D. M. (2025). Nursing in Critical Care, 30(3). https://doi.org/10.1111/nicc.70056

Hospital Pharmacy, 57(6). https://doi.org/10.1177/00185787221095771

NURS FPX 6016 Assessment 3 Quality Improvement Initiative Evaluation

Moustafa, N., Hafez, A. A., Hendy, A., Ibrahim, R. K., Kotp, M. H., Baghdadi, N. A., & Ahmed, S. R. (2025). BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03553-4

Reddy, N., Verma, N., & Dungan, K. (2020). In www.ncbi.nlm.nih.gov. MDText.com, Inc. https://www.ncbi.nlm.nih.gov/sites/books/NBK279046/

Rosen, M. A., Romig, M., Demko, Z., Barasch, N., Dwyer, C., Pronovost, P. J., & Sapirstein, A. (2021). BMJ Quality & Safety, 30(11), 893–900. https://doi.org/10.1136/bmjqs-2020-011420

Ștefan, A.-M., Rusu, N.-R., Ovreiu, E., & Ciuc, M. (2024). Applied System Innovation, 7(3), 51. https://doi.org/10.3390/asi7030051

St. Mary’s Medical Center. (2025). Home – St. Mary’s Medical Center. Www.st-Marys.org. https://www.st-marys.org/

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Answer 2: Evaluation of insulin safety through interprofessional collaboration.