PDSA Cycle in Nursing

PDSA Cycle in Nursing

Discussion

Using the PDSA cycle, describe your proposed DNP project to your peers. Select at least 2 of the tools from Table 21.1 of your text and describe how they might be used in your DNP project. Please note this activity is for the purpose of this course only and should not override whatever has been decided for the DNP project plan. Please be sure to include the interprofessional team.

DNP Project

 Improving depression screening of adolescents at primary care

 

PDSA Cycle in Nursing

PDSA Cycle

Application of PDSA Cycle on Description of DNP Project

The Proposed DNP Project

For the DNP project that has been proposed, the goal would be accomplished by enhancing the staff knowledge in the context of adolescent primary care settings’ depression screening. It is aimed at increasing the efficacy of diagnosis and intervention on depressive disorders in adolescents so that their mental health can be effectively safeguarded.

The PDSA Cycle

PDSA cycle also known as the Plan-Do-Study-Act cycle is a systematic approach of five steps to acquiring useful learning and knowledge used in the ongoing improvement of a product or process. It is comprised of four phases:

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 Plan: Find a motive/mission, develop/disperse a hypothesis, establish standards for what constitutes achievement, and implement a strategy (Minian et al., 2024).

Do: Try the plan on a few people or groups of people, and then begin progressively expanding it out to a larger population.

Study: Set outcomes to check how far the intended plan has been effective.

Act: According to Minian et al., (2024), If the plan worked, revise it and then it should be scaled up and frequent checks done on the outcome. If the plan fails, go back to the start of the circle.

 Plan: The planning phase entails a clear identification of the goals in addition to the strategies that are to be taken in pursuance of the said goals. The strategy for the current project involves giving a health awareness talk to the clinicians working in the local pediatric clinic about adolescent depression and using a reliable depression screener. The intended outcome is to change the rates of depressive symptoms among adolescents through screening during preventive care services, increase the likelihood of early identification and intervention, as well as enhance Provider and Staff knowledge.

Interprofessional Team

Members of the interdisciplinary care team involved in the project plan include:

  1. Project Manager: It supervises the proper execution of all the phases of the PDSA cycle involved in the implementation of the project.
  2. Pediatricians: Conduct the depression screening and if there is a need for treatment offer the treatment or refer the patient to the necessary center.
  3. Nurses: Participate in screening and the procedures that are followed after that.
  4. Mental Health Specialists: Expand the availability of support and professional assistance in handling the discussed cases of depression (Giardino & Hickey, 2020).
  5. Administrative Staff: Consultation on educational sessions’ timetables and practical assistance in organizing them.

 Do

In the Do phase, the working and practical implementation of the intervention plan will occur in ten weeks; it will consist of phases and activities that will promote learning and better skills. Weeks 1-5: Concentrate on the participant sampling and the first data-gathering tasks. Assessment quizzes will be conducted to identify the clinic staff’s level of knowledge before educational session one. The educational content that will be provided will concern the PHQ-9 screening tool, possible manifestations of depression in teenagers, and the process of their early identification and referral. To facilitate the learner’s engagement, presentations will be made in small groups to encourage a discussion approach. There will also be private appointments for anyone who will be unable to make group appointments.

Weeks 6-8: Here, the focus shall be on how far we have gone and the feedback received. It will also be the role of the participants to check on their progress and see if they are implementing what they have learned. Furthermore, the instructors’ opinions will be collected to determine which topics require more attention or explanation. Weeks 9-10: Specialized for post-tests, data collection, data entry, and data analysis activities. The post-tests will check the enhancement of the participants’ knowledge and the efficacy of the educational program PDSA Cycle in Nursing.

Study

The last step for conducting an EPET analysis is the “Study” phase where the effectiveness of the performed intervention has to be assessed. In the last two weeks of the intervention, data will be collected, entered into the computer, and analyzed. The data obtained shall be used to evaluate the overall efficacy of the intervention in increasing the competencies of clinic staff in the recognition and treatment of adolescent depressive disorder.

Act

Regarding the “Act” phase, it is going to be the stage where the next steps for the “Study” phase findings will be made. The specific goals for the measurable outcomes expectations are to complete a minimum of 10 percent more PHQ-9 screens correctly among adolescents aged 12 years and above during annual visits and to increase the clinic staff knowledge by 10 percent. Again, from the recommendations deduced from the discoveries, alterations will be made, and if the targeted outcomes still have not been achieved, then the plan will be examined to recognize and fill any possible voids.

Tools for Quality Improvement

 A Pareto Chart

A Pareto Chart is one of the most important tools for quality improvement in the organization; it enables them to recognize the most dramatic problems that require improved processes or outcomes by demonstrating the most often occurring root causes or consequences. It helps teams/individuals to concentrate on major concerns as it provides data in a descending manner concerning the frequency and impact of problems. Analyzing the Pareto chart, a small number of the causes contain a significant percentage of the issues, which helps with appropriate focus and resource utilization (Alkiayat, 2021). The bright graphic map encourages stakeholders’ attention; frequent updates provide control of activities and adjustments to the plan. It also helps to carry out root cause analysis, leading to the applicable interventions that would bring long-term compensations. For instance, in the context of a CDSS implementation project, a Pareto Chart will point out the major impediments to patient screenings, including lack of time and forgetfulness, among others so that improvement initiatives can be directed toward addressing these factors.

Root Cause Analysis

A root cause analysis (RCA) is a procedure for determining why a trouble happens. Since a cause has been identified, it will be easier to come up with the correct measures to avoid a repeat of the same again. What RCA can reveal for this project is why the providers are not present to screen the patient. Some of the possible reasons may be because of time crunch, forgetting, no standardized system implemented, or they may have a lot of work to do (Martin-Delgado et al., 2020). The primary causes of these barriers will be sought by coming up with focused strategies to tackle these problems and enhance the percentage of screening PDSA Cycle in Nursing.

Conclusion

This DNP project seeks to improve depression screening practices in adolescent primary care settings through the application of the PDSA cycle and other tools including flowcharts and other methods of continuous improvement. By developing a partnership over time and embedding changes in practice, the project aims to increase the detection and management of adolescent depression for better patient outcomes within the urban pediatric group.

 

References

Alkiayat, M. (2021). A practical guide to creating a Pareto chart as a quality improvement tool. Global Journal on Quality and Safety in Healthcare, 4(2), 83-84. https://doi.org/10.36401/JQSH-21-X1

Giardino, E. R., & Hickey, J. V. (2020). Doctor of Nursing Practice Students’ perceptions of professional change through the DNP program. Journal of Professional Nursing, 36(6), 595-603. https://doi.org/10.1016/j.profnurs.2020.08.012

Martin-Delgado, J., Martínez-García, A., Aranaz, J. M., Valencia-Martín, J. L., & Mira, J. J. (2020). How much of root cause analysis translates into improved patient safety: a systematic review. Medical Principles and Practice, 29(6), 524-531. https://doi.org/10.1159/000508677

Minian, N., Gayapersad, A., Coroiu, A., Dragonetti, R., Zawertailo, L., Zaheer, J., … & Selby, P. (2024). Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study. Frontiers in psychiatry, 15, 1286078. https://doi.org/10.3389/fpsyt.2024.1286078

Yildirim, U., & Campean, F. (2020). Functional modelling of complex multi-disciplinary systems using the enhanced sequence diagram. Research in Engineering Design, 31(4), 429-448. https://link.springer.com/article/10.1007/s00163-020-00343-8  PDSA Cycle in Nursing