Quality Improvement In Nursing

Quality Improvement As advanced practice nurses (APNs), understanding quality improvement is an important competency that must be grasped. There are several health illnesses that need to have quality improvement initiatives placed. One such illness is hypertension (HTN), or high blood pressure. Early identification and treatment of hypertension using a hypertension algorithm is the selected quality improvement initiative. HTN is a highly prevalent illness that affects an estimated 70 million people in the United States (CDC, 2015). This paper will provide the background of HTN, will discuss a theoretical underpinning of change, will explain how an improvement tool can be used to further understand HTN, will discuss a quality model, will discuss
Eric Havelock’s theory is one that expands on Lewin’s model of change. Havelock’s theory consists of six aspects: (1) relationship, (2) diagnosis, (3) acquiring resources for change, (4) selecting a pathway, (5) establish and accept change, and (6) maintenance and separation. Havelock believed that a system in need of change should first establish a relationship with the change agent, and the change agent should determine if the system truly needs change. Once the need for change is established, resources for change should be acquired and available option should be implemented. Then, the change should be established as well as accepted by those involved in the system. Finally, the successful change should be monitored to ensure that success is maintained (Tyson, 2010). Staff engagement, commitment, empowerment, and ownership are important aspects that can be fostered by Havelock’s Theory of Change concepts. Developing a relationship, the first step, is closely related to staff engagement. With early detection of hypertension, staff should actively engage themselves in learning about the patient’s history, compliance with medications, and lifestyle habits. Staff can then grasp an understanding if the patient needs to make changes. Commitment ensures that staff members desire and want to acquire the resources needed for change, which exemplifies the third step of Havelock’s Theory of Change.
The first step is to develop a plan and establish the objective of the plan. The second step is to carry out, or do, the plan. The third step is to study the plan. In other words, the data should be analyzed, and a summary of what was learned should be given. The fourth step is to act. The next continuous cycles should be established with modifications, if necessary (Gillam & Siriwardena,