service improvement project dissertation

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Service Improvement Project

Paper completed for my Nursing degree dissertation. It discusses the implementation of a patients DNACPR status and its identification on a patients wristband. The text follows a hypothetical project to implement the service improvement within an NHS trust; including research, stakeholder engagement and change implementation at a ward level.

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Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation

Affiliations.

1 Faculty of Health and Social Care, London South Bank University London, United Kingdom; University College London Hospitals, London, United Kingdom. Electronic address: [email protected].
2 Faculty of Health and Social Sciences, University of Bedfordshire, United Kingdom. Electronic address: [email protected].
3 Faculty of Health and Social Sciences, University of Bedfordshire, United Kingdom. Electronic address: [email protected].
4 University of Surrey, Guildford, Surrey, United Kingdom. Electronic address: [email protected].
5 University of Bedfordshire, United Kingdom. Electronic address: [email protected].
PMID: 23867284
DOI: 10.1016/j.nepr.2013.06.006

Background: Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations.

Aim: The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum.

Method: A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach.

Results: Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff.

Conclusion: Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential.

Keywords: Clinical practice; Dissertation; Evaluation; Service improvement projects; Student nurses.

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Developing and sustaining nurses' service improvement capability: a phenomenological study

Subject Lead, Adult Nursing, and Senior Lecturer, Northumbria University, Newcastle upon Tyne

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Alison Machin

Professor of Nursing and Interprofessional Education, Northumbria University/Executive Member (workforce), Council of Deans of Health

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Background:

Service improvement to enhance care quality is a key nursing responsibility and developing sustainable skills and knowledge to become confident, capable service improvement practitioners is important for nurses in order to continually improve practice. How this happens is an under-researched area.

A hermeneutic, longitudinal study in Northern England aimed to better understand the service improvement lived experiences of participants as they progressed from undergraduate adult nursing students to registrants.

Twenty year 3 student adult nurses were purposively selected to participate in individual semi-structured interviews just prior to graduation and up to 12 months post-registration. Hermeneutic circle data analysis were used.

Themes identified were service improvement learning in nursing; socialisation in nursing practice; power and powerlessness in the clinical setting; and overcoming service improvement challenges. At the end of the study, participants developed seven positive adaptive behaviours to support their service improvement practice and the ‘model of self-efficacy in service improvement enablement’ was developed.

Conclusion:

This study provides a model to enable student and registered nurses to develop and sustain service improvement capability.

Embedding a nursing service improvement culture has been a focus of successive UK policy initiatives ( Craig, 2018 ), such as the NHS Safety Thermometers scheme ( NHS Improvement, 2017 ), the 2012 nurse-led quality framework Energise for Excellence, High Impact Actions for Nursing and Midwifery ( NHS website, 2010 ) and the NHS Productive Series ( NHS website, 2020 ). However, information about how nurses develop and sustain service improvement skills beyond their initial education is lacking.

Service improvement can be defined as ‘the combined efforts of everyone to make changes, leading to better patient outcomes (health), better system performance (care) and better professional development (learning) regardless of the theoretical concept or tool utilised’ ( Batalden and Davidoff, 2007:2 ).

In 2007, a national initiative to embed this learning in undergraduate programmes created many opportunities for pre-registration nursing students to develop these skills ( Johnson et al, 2010 ). Students involved in the initiative evaluated it very positively and subsequent studies suggest it enhanced their understanding of the practicalities of implementing service improvement activity ( Machin and Jones 2014 ). Johnson et al's (2010) study suggested that resistance from staff, lack of time and student status were barriers to the success of students' service improvement efforts. Despite challenges, service improvement learning and the opportunity to improve the patient care experience is valued by pre-registration students ( Smith and Lister, 2011 ), with classroom-based sessions seen as beneficial for learning ( Baillie et al, 2014 ; Smith et al, 2014 ). Educational programmes encompassing service improvement have helped prepare student nurses to make changes in practice when qualified ( Machin and Jones, 2014 ; James et al, 2016 ). However, little is known about the sustainability of this learning.

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Implementing service improvement projects within pre-registration nursing education: A multi-method case study evaluation

Background Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. Aim The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. Method A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994)) Framework Approach. Results Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Conclusion Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential.

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Using service improvement methodology to change practice, william gage lead nurse for practice development and innovation, imperial college healthcare nhs trust, london..

This article discusses the role of service improvement methodology in changing the quality of care delivered. It outlines the six-stage framework for quality improvement recommended by the NHS Institute for Innovation and Improvement. The reader is encouraged to complete a series of activities to plan and deliver a service improvement project. Potential challenges to the successful delivery of a service improvement project are also considered. The article concludes with an example of the use of the six-stage framework to improve the quality of urinary catheter care in one acute NHS trust.

Nursing Standard . 27, 23, 51-57. doi: 10.7748/ns2013.02.27.23.51.e7241R1

This article has been subject to double blind peer review

Received: 03 October 2012

Accepted: 16 November 2012

management - leadership - quality - change management - quality improvement - service improvement

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Dissertation

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This is the final course in the BSc (Hons) Clinical Practice degree pathway.

By undertaking the dissertation, in the form of a service improvement project, practitioners will gain the skills and knowledge necessary to implement and evaluate a project in practice.

Course requirements: You must have successfully completed 80 credits at Level 6, prior to applying for this final module in the BSc (Hons) pathways.

Cost and funding: This fee covers the full course cost.

Sept 24 - Aug 25 fees: £1800
Sept 25 - Aug 26 fees: TBC

Credits: 40

Assessment method: Poster presentation 25% and critique 75%

Clinician typing on a laptop with bare arms and medical equipment next to her.

Study dates and times

This course is taught on day release, select a start date to see the study days:

Study days are from 9am to 4pm.

The course will focus on:

Models and theoretical underpinnings of evidence-based practice; emerging policies, guidelines and literature eg PDSA cycle
Working within an evaluation framework
Developing a proposal including work plan for the identified practice/ service improvement project
Setting, monitoring and measuring SMART goals
Evaluation and monitoring strategies with relevant tools and measures designed to assist in the change management process
Change management theories, skills and strategies
Project development models and approaches
Clinical audits and other tools for mapping service development needs and establishing targets for changes
Engagement and consultation with major stakeholders, including service users and carers
Networking and consultation with leading specialists and champions
Overcoming barriers in implementing evidence-based practice
Leadership skills and knowledge
Presentation and publication skills for disseminating projects
Systematic and evidence-based evaluation of the service improvement.

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I am currently seconded to UWL from clinical practice two days per week. I facilitate and teach on the Foundation Practice Nurse course. I work one day per week in family planning and sexual health and have my FSRH Diploma and am a specialist family planning nurse. Part of my role has been to deliver the Cervical Cytology course and I have been providing this training for the past eight years at UWL.

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This is the final module in the BSc (Hons) Clinical Practice degree pathway.

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Welcome to your Service Improvement project reading list. Here you will find the resources to support you throughout this module.

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International Nursing Review
Journal of Advanced Nursing
Journal of Interprofessional Care
Journal of Nursing Management
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Martin Marshall , lead 1 ,
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1 Improvement Science London, London W1T 7HA, UK
martin.marshall{at}islondon.org

Oldham describes “death by research” as one of the barriers to effective reform of health services. 1 He is correct that established approaches to generating and using research often have little impact on efforts to improve care. But his assertion that the “culture of evidence” is incompatible with a culture of …

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Fertility and Ecotoxicological State of Reference Sites of Gray Forest Soils in Vladimir Oblast

EXPERIMENTAL ARTICLES Soil Fertility
Published: 14 December 2022
Volume 48 , pages S11–S20, ( 2022 )

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A. A. Utkin 1 &
S. N. Lukyanov 2

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The paper presents the results of the long-term agrochemical and ecotoxicological studies of reference sites of the gray forest soil farmlands in Vladimir oblast, which were carried out to establish a level of fertility based on the major agrochemical indicators and content of micronutrients and sulfur as well as ecotoxicological state based on content of the gross and mobile forms of heavy metals. The deterioration of soil fertility indicators was established, such as supply of organic matter, mobile forms of phosphorus and potassium, exchange bases of calcium and magnesium, and the exchangeable and hydrolytic acidity. Soil fertility was assessed by calculating the soil-ecological index. The study determined soil availability of boron, molybdenum, copper, and mobile sulfur. Concentrations of the gross and mobile forms of heavy metals in the surveyed soils did not exceed permissible limits. According to the content of the considered metals, the studied soils are slightly polluted and do not pose a hazard for cultivated plants and human health. The Pearson correlation coefficients served to establish a distinctive nature of the effect of the soil properties on concentrations of micronutrients, sulfur, and gross and mobile forms of metals.

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A. A. Utkin

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Utkin, A.A., Lukyanov, S.N. Fertility and Ecotoxicological State of Reference Sites of Gray Forest Soils in Vladimir Oblast. Russ. Agricult. Sci. 48 (Suppl 1), S11–S20 (2022). https://doi.org/10.3103/S1068367422070217

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Received : 31 October 2021

Revised : 07 November 2021

Accepted : 15 December 2021

Published : 14 December 2022

Issue Date : December 2022

DOI : https://doi.org/10.3103/S1068367422070217

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We, the U.S. Fish and Wildlife Service (Service), have received two applications for incidental take permits (ITPs) under the Endangered Species Act of 1973, as amended (ESA; 16 U.S.C. 1531 et seq. ). The applicants have developed draft habitat conservation plans (HCPs) for the respective projects that include measures to minimize and mitigate impacts to the federally threatened Central California DPS of the California tiger salamander ( Ambystoma californiense ) and California red-legged frog ( Rana draytonii ). Each of the permits, if granted, would authorize take of the California tiger salamander and California red-legged frog incidental to otherwise lawful activities associated with the development and improvement of school facilities in the cities of San Juan Bautista and Salinas in San Benito and Monterey Counties, respectively, in California. We invite public comment on the applications, which include the applicants' HCPs, and on the Service's preliminary determination that both proposed ITPs qualify as low effect, and may qualify for categorical exclusions pursuant to the Council on Environmental Quality's National Environmental Policy Act (NEPA) regulations ( 40 CFR 1501.4 ), the Department of the Interior's (DOI) NEPA regulations ( 43 CFR 46 ), and the DOI's Departmental Manual (516 DM 8.5(C)(2)). To make these preliminary determinations, we prepared draft low-effect screening forms, which are also available for public review.

The Service listed the Central California DPS of the California tiger salamander as threatened on August 4, 2004 ( 69 FR 47212 ), and listed the California red-legged frog as threatened on May 23, 1996 ( 61 FR 25813 ). Section 9 of the ESA prohibits “take” of fish and wildlife species listed as endangered ( 16 U.S.C. 1538 ), where take is defined to include the following activities: “to harass, harm, pursue, hunt, shoot, wound, kill, trap, capture, or collect, or to attempt to engage in any such conduct” ( 16 U.S.C. 1532 ). The take prohibitions of section 9 are extended to species listed as threatened at the discretion of the Secretary of the Department of the Interior; in this case, they were extended to both species; however, this was done with exceptions for the California tiger salamander.

Under section 10(a)(1)(B) of the ESA ( 16 U.S.C. 1539(a)(1)(B) ), we may issue permits to authorize take of listed fish and wildlife species that is incidental to, and not the purpose of, carrying out an otherwise lawful activity. Regulations governing incidental take permits for endangered and threatened species are in the Code of Federal Regulations (CFR) at 50 CFR 17.22 and 17.32 , respectively. Issuance of an ITP also must not jeopardize the existence of federally listed fish, wildlife, or plant species, pursuant to section 7 of the ESA and 50 CFR 402.02 . The permittee would receive assurances under our “No Surprises” regulations ( 50 CFR 17.22(b)(5) and 17.32(b)(5) ).

Each applicant has applied for a permit for incidental take of the California tiger salamander and California red-legged frog. The take would occur in association with development and improvement activities of school facilities.

The respective HCPs include minimization measures for the California tiger salamander and California red-legged frog and mitigation for unavoidable take and loss of suitable habitat for these species. As mitigation for take and loss of suitable habitat, the applicants propose mitigation that will support the recovery goals of the species such as restoration and protection of habitat through the purchase of credits at a conservation bank.

The Service has made a preliminary determination that the applicants' proposed projects, and proposed mitigation and minimization measures, would individually and cumulatively have a minor effect on the species and the human environment. Therefore, we have preliminarily determined that the proposed ESA section 10(a)(1)(B) permits would be low-effect ITPs that individually or cumulatively would have a minor effect on the species and may qualify for application of categorical exclusions pursuant to the Council on Environmental Quality's NEPA regulations, DOI's NEPA regulations, and the DOI Departmental Manual. A low-effect ITP is one that would result in (1) minor or nonsignificant effects on species covered in the HCP; (2) nonsignificant effects on the human environment; and (3) impacts that, when added together with the impacts of other past, present, and reasonably foreseeable actions, would not result in significant cumulative effects to the human environment.

The Service will evaluate the applications and the comments received to determine whether to issue the requested ITPs. We will also conduct an intra-Service consultation pursuant to section 7 of the ESA to evaluate the effects of the proposed covered activities on the Central California DPS of the California tiger salamander and California red-legged frog. After considering the preceding and other matters, we will determine whether the permit issuance criteria of section 10(a)(1)(B) of the ESA have been met. If met, the Service will issue one or both ITPs.

Before including your address, phone number, email address, or other personal identifying information in your comment, you should be aware that your entire comment, including your personal identifying information, may be made publicly available at any time. While you can ask us in your comment to withhold your personal identifying information from public view, we cannot guarantee that we will be able to do so.

We provide this notice under section 10(c) of the Endangered Species Act ( 16 U.S.C. 1531 et seq. ) and its implementing regulations ( 50 CFR 17.32 ) and the National Environmental Policy Act ( 42 U.S.C. 4321 et seq. ) and its implementing regulations ( 40 CFR 1500-1508 and 43 CFR 46 ).

Stephen P. Henry,

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Figure 30. Service design days agenda. 63 Figure 31. Hasso-Plattner 5 steps to design thinking (Traifeh, 2019, pp. 165-169). 64 Figure 32. Service design force field analysis. 66 Figure 33. Improvement methods used by development teams. 68 Figure 34. Cause and effect diagram categories (Westcott, 2006b, pp. 329-371). 69 Figure 35. Cause and ...
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service improvement process implementation. It will study in high-level well-known improvement methods to the point that helps to understand which of them would suite best in the actual implementation process. The thesis will contain a start of a real-life project to illustrate how things where done by the project team to the point where
Service improvement in health care: a literature review
Abstract. Service improvements in health care can improve provision, make cost savings, streamline services and reduce clinical errors. However, on its own it may not be adequate for improving patient outcomes and quality of care. The complexity of healthcare provision makes service improvement a challenge, and there is little evidence on ...
Implementing service improvement projects within pre-registration
A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. Aim: The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum.
Developing and sustaining nurses' service improvement capability: a
Embedding a nursing service improvement culture has been a focus of successive UK policy initiatives (Craig, 2018), such as the NHS Safety Thermometers scheme (NHS Improvement, 2017), the 2012 nurse-led quality framework Energise for Excellence, High Impact Actions for Nursing and Midwifery (NHS website, 2010) and the NHS Productive Series (NHS website, 2020).
PDF Increasing Service Quality at a University: A Continuous Improvement
Improvement Project Journal: Quality Assurance in Education Manuscript ID QAE-02-2021-0020.R4 ... associated implementation actions were not explored to assess the service quality improvement impacts as continuous improvement projects (CIPs). CIPs, such as Kaizen ... (thesis) to solve a specific manufacturing or service organisation problem. 4 ...
Implementing service improvement projects within pre-registration
This was achieved at the authors' university, by embedding service improvement into the 2009 curriculum, and instigating a service improvement project as the degree students' dissertation. This strategy has been sustained in the new all-degree curriculum, based on the NMC's (2010) standards.
Service improvement in health care
This extract from NHS 2010-2015: from good to great: preventative, people-centred, productive indicates that the quality of care remains an enduring concern in the organisation and management of health care.Indeed in the English National Health Service there has been a major policy drive to address the twin challenges of service quality and patient safety.
PDF Northumbria Research Link
However, service improvement alone may not be adequate in improving patient outcomes and quality of care. Complexity of healthcare provision makes service improvement a challenge, and there is little evidence of whether service improvement initiatives change healthcare practice and improve patient care.
Implementing service improvement projects within pre-registration
The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff.
Service improvement in health care: a literature review
Service improvements in health care can improve provision, make cost savings, streamline services and reduce clinical errors. However, on its own it may not be adequate for improving patient outcomes and quality of care. The complexity of healthcare provision makes service improvement a challenge, and there is little evidence on whether improvement initiatives change healthcare practices and ...
(PDF) Practical guidance on undertaking a service evaluation
An online questionnaire was used to gauge acceptability of the project among frontline Ambulance Service Trust staff. Results: CAST attended 178 OHCAs and committed a median of three (IQR 2-3 ...
PDF MSc Integrated Service Improvement School of Health in Social Science
supporting service users towards maximising independence and making them less reliant on services in the future. Consequently, the time savings that can be realised are then used to offset increased demand, effectively doing more with less. A recent report (Joint Improvement Team, 2013) on Scotland's thirty-two local authorities'
Using service improvement methodology to change practice
Potential challenges to the successful delivery of a service improvement project are also considered. The article concludes with an example of the use of the six-stage framework to improve the quality of urinary catheter care in one acute NHS trust. Nursing Standard. 27, 23, 51-57. doi: 10.7748/ns2013.02.27 ...
Dissertation
By undertaking the dissertation, in the form of a service improvement project, practitioners will gain the skills and knowledge necessary to implement and evaluate a project in practice. Course requirements: You must have successfully completed 80 credits at Level 6, prior to applying for this final module in the BSc (Hons) pathways.
Service Improvement Project
Welcome to your Service Improvement project reading list. Here you will find the resources to support you throughout this module. ... It is vital reading for all those doing their undergraduate dissertation or any study which involves doing a literature review. ... The book's coverage of state-of-the-art research concepts and approaches ...
Good research is essential for service improvement
Good research is essential for service improvement. Oldham describes "death by research" as one of the barriers to effective reform of health services. 1 He is correct that established approaches to generating and using research often have little impact on efforts to improve care. But his assertion that the "culture of evidence" is ...
Kosteryovo
Kosteryovo ( Russian: Костерёво) is a town in Petushinsky District of Vladimir Oblast, Russia, located on the Lipnya River ( Klyazma 's tributary ), 52 kilometers (32 mi) west of Vladimir, the administrative center of the oblast. Population: 7,113 ( 2021 Census); [7] 9,073 ( 2010 Russian census); [2] 9,608 ( 2002 Census); [8] 11,777 ...
Siemens to have new service depot in Vladimir
Until the end of 2016, the first phase of the project will be completed, Inna Khromenkova, Acting Director of the Vladimir Oblast Department for Investments and Foreign Trade, said. In total, there are three phases to be completed within 51 months. The ROI of the project is five years; the depot will provide maintenance for 6,000 cars yearly.
Fertility and Ecotoxicological State of Reference Sites of ...
Abstract The paper presents the results of the long-term agrochemical and ecotoxicological studies of reference sites of the gray forest soil farmlands in Vladimir oblast, which were carried out to establish a level of fertility based on the major agrochemical indicators and content of micronutrients and sulfur as well as ecotoxicological state based on content of the gross and mobile forms of ...
Vladimir Oblast
federal subject of Russia
Endangered and Threatened Wildlife and Plants; Two Draft Habitat
As part of the application for an ITP, each applicant submitted a draft habitat conservation plan for their respective project. For each project, the Service prepared a draft screening form in accordance with the National Environmental Policy Act (NEPA) to evaluate the potential effects to the natural and human environment resulting from ...