ND-301: Quality Improvement Project 1

Desire Wentzell

Quality Improvement Project

ND-301

Marywood University
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Problem 2:

While looking in the dementia units pantry refrigerator, you notice that there are several days
worth of supplements in the fridge, each labeled with the residents names, and times/dates they were
supposed to be given. Later while charting, you notice that nursing has documented that several of
the supplements still in the fridge were consumed 100% by the residents. How would you address
and monitor this?

Some causes of the problem may include, but are not limited to, the nurses not working in a

timely manner to give residents their supplements each day, nurses may be lazy or unaware of the

supplements that are supposed to be given, or nurses may mark the document as 100% consumed

before giving the residents their supplements, in turn, forgetting to do so.

To address this issue both department head managers and the building/facility manager should

be notified that some residents are not receiving their daily nutritional supplements. From there, nurses

should be given a set time each day as to when they are supposed to give the residents their

supplements. The nursing department, nutrition department, food service director, and maybe even an

administrator/head manager of both departments to oversee the transition goes smoothly should be

involved.

The nurses should record data on a sheet with the date, time, and residents name that the

supplements are being given to, at the set time it is supposed to be given each day. These actions and/or

sheets should then be overseen by a manager stating that the residents have received their proper

supplements at the proper time. A meeting would be held to inform all nurses of the new/current

procedure in place. The nurses will be shown the new form that is to be filled out daily, explaining the

elements that are on the data sheet and the consequences to not filling out the form correctly/daily.

Each nurse will be given a form for those residents that they are in charge of during their daily tasks

and shifts, to ensure each resident is being taken care of more thoroughly. The nurses would then
ND-301: Quality Improvement Project 3

record their own supplement sheet on the main supplement sheet on the refrigerator in the dementia

unit.

In theory this is what the QI form would like. Each nurse would fill out the name of the

resident, the time, and date of residents supplement(s) being taken. The nurse would then sign their

own initials on the form and continue with their daily duties. This form would be checked daily by the

Food Service Director/RD and the head of the nursing department. Each of these forms would then be

evaluated weekly and/or monthly to ensure each nurse is giving the correct supplements, correct

amount of each supplement, and at the correct time and date, to the right resident.

If the form is not followed/filled out daily severe measures would be taken. Each nurse who

missed giving the residents their supplements would then be written up once, and if it happened again

the nurse would be terminated. This form would hang on the refrigerator door in the dementia unit in

order to ensure the form is seen before and after the residents receive their supplements, for the nurses

to record their data from their own sheets daily.

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Resident Supplements Date Time Initial of Date When Time Initial of

Name Taken/Amount Taken Taken Nurse Finished When Nurse
Consumed Finished

*John Iron/ 100% 10/20/16 4:00pm DW 10/26/16 4:00pm DW

Smith Protein/ 100%

**This is an example of how the QI form would be filled out. In reality all columns and rows would
be filled out with all of the residents names in the dementia unit. This resident was given two
supplements for six days, with a start and an ending time of the supplement. The nurse initialed
where indicated, ensuring all of the supplement has been taken.**