Advanced Nursing Practice Field Experience
Lolita Knight
Proposal Form
Please refer to separate submission in Taskstream
CHSI is committed to providing the best quality medical care possible for its population of underserved patients. This summary addresses my proposal for the Advanced Nursing
Practice Field experience. One new policy recommended by the Riverside County Health
Department is to include HIV screening and testing with all routine physical exams. The organizational change I am investigating is increasing provider compliance by including HIV
screening and testing with routine physical exams. The population affected by this change will be the underserved population in Riverside County. My change leader is Evelyn Pearson-
Ray MSN, RNP, and Nurse Educator for the organization. My plan for conducting this investigation is to create a team of stakeholders, measure provider compliance of including HIV
screening and testing with routine physical exams, evaluate staff knowledge, provide necessary training, re-evaluate staff's knowledge of HIV screening and testing, evaluate patient population, review current and new policy for HIV screening and testing, implement policy changes, re-
measure as needed, analyze and evaluate results. This paper reviews this initiative and provides an overview of an analytical approach to evaluate its effectiveness.
C. Completion of QIA Form
Please refer to separate document submitted in Taskstream
C1. Summary of Data Collected
HIV screening and testing study time period was July 2013 to July 2014. The goal was to increase HIV screening and testing with routine physical exams. Provider compliance was 65%
in July 2013 and increased to 95% since implementation of policy. Goal met at 95%.
Section I.
This section of the Quality Improvement Activity (QIA) form addresses selection and methodology. The reason this project was important to my organization is because
HIV screening and testing will increase patient education, testing, and treatment of HIV by identifying status and prevention of complications and transmission. The quantifiable measure for this study was to increase the number of patients screened and tested for HIV during routine physical exams. No benchmark was used in this project. This study was established by recommendation of the riverside county health department. The baseline goal of this study was an organizational goal of 95% by increasing provider compliance to test and screen for HIV
during routine physical exams. Data sources included were patient medical records. Data was collected from 20 patient charts every quarter totaling 100/year. Random sampling technique was used for this study.
Section II.
Section two of the form describes the actual data collected and results. An initial baseline rate of
65% provider compliance in the first quarter of July 2013. The first measure of provider compliance was at the rate of 75% in October 2013, with an improvement of 10% from the baseline. Re-measurement 2 was at 85%, with an increase of 10% from the previous quarter. Re-measurement 3 was at 90% provider compliance, with a 5% increase from the last quarter. The last quarter of re-measurement 4 was at 95% Goal met, improvement by 5% from last quarter and overall improvement by 30%. No further re- measurement required.
Section III.
Section three addresses the analysis cycle of the project. The analysis took place over one calendar year July 2013 to July 2014 and covers one quantifiable measure. In comparison to the initial measurement of 65%, rates continued to improve over the next reported period showing quarterly until the goal was met at 95%; with an overall improvement by 30
percent. No changes to goals implemented in this study. No national benchmarks for this study.
The overall trend of the post data implementation did not require re-measurement due to provider compliance goals having been met. Each quarter's results were compared to previous measurements to determine if progress towards the objective achievement were made.
Section IV.
This section of the QIA form addresses the interventions that were implemented to influence change. The interventions that had the most impact on this change project were building the team including the clinic administrator, nurse educator, nurse manager, and nurse practitioner to review, revise, and approve policies and procedures and implementation of staff training for HIV
screening and testing. The interventions addressed the barriers of personnel lacking adequate training in HIV medicine.
C1a. Data Collection Methods Used:
As previously described in the summary and complete QIA form, data sources for this intervention included medical records of patients that received routine physical exams at the clinic.
C1b. Appropriateness
The data collection methods were appropriate because Retrospective analysis of clinical data is often found in the patient's medical record; however, this method of data collection...
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