Submit your final paper on your personal or professional quality improvement project. This project will incorporate key concepts discussed in the course, including the Model for Improvement, to guide...

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Submit your final paper on your personal or professional quality improvement project.


This project will incorporate key concepts discussed in the course, including the Model for Improvement, to guide the learner to improve a process. Some elements in IHI QI Essentials Toolkit will be used to structure the project which include the Key Driver Diagram, the PDSA Worksheet, and the Project Planning Form. This project will be met by:



  • Identifying a problem

  • Completing a literature search to identify best practice

  • Obtaining baseline data to compare current practice to best practice

  • Identifying key stakeholders needed for improvement

  • Developing an AIM Statement with a Key Driver Diagram to identify changes needed to achieve the aim

  • Establishing a family of measures – process, outcome, and balancing measures including operational definitions of each measure

  • Testing the changes with PDSA cycles

  • Collecting data

  • Displaying data on an annotated run chart

  • Evaluating if the changes led to an improvement

  • Recommending next steps for improvement and sustainability of the work



The completed project will be submitted as a 11–15-page document to include the following:




Submit your final paper on your personal or professional quality improvement project.  This project will incorporate key concepts discussed in the course, including the Model for Improvement, to guide the learner to improve a process. Some elements in IHI QI Essentials Toolkit will be used to structure the project which include the Key Driver Diagram, the PDSA Worksheet, and the Project Planning Form. This project will be met by: · Identifying a problem · Completing a literature search to identify best practice · Obtaining baseline data to compare current practice to best practice · Identifying key stakeholders needed for improvement · Developing an AIM Statement with a Key Driver Diagram to identify changes needed to achieve the aim · Establishing a family of measures – process, outcome, and balancing measures including operational definitions of each measure · Testing the changes with PDSA cycles · Collecting data · Displaying data on an annotated run chart · Evaluating if the changes led to an improvement · Recommending next steps for improvement and sustainability of the work   The completed project will be submitted as a 11–15-page document to include the following:   Headings Recommended page length Background / Literature search 1.5-2.0 Project Aim – outcome measures Process and balancing measures 0.5-1.0 Project setting and population of focus Project date 0.5 Changes / Interventions 1.0-1.5 Data Collection – What information is needed? 0.5 Results 1.0-2.0 Discussion / Evaluation 2.0 Recommendations on next steps including plan for sustainability 1.0-2.0 References 1.0 Appendix 1 – Key Driver Diagram 1.0 Appendix 2 – PDSA Worksheet 1.0 Rubric Professional Quality Improvement Project Professional Quality Improvement Project Criteria Ratings Pts This criterion is linked to a Learning OutcomeBackground / literature search 3 pts EXCELLENT Completely identifies the situation and describes the need for a change to occur. At least 3 evidence-based practice journal articles are utilized. 2 pts DEVELOPING SKILL Mostly identifies the situation and describes the need for change to occur. At least 2 evidenced-based articles are utilized. 1 pts DID NOT MEET EXPECTATIONS Inadequately identifies the problem and/or includes insufficient journal articles. 3 pts This criterion is linked to a Learning OutcomeKey driver program 4 to >3.0 pts . Key Driver Diagram completed on time with appropriate aims, primary and secondary drives, and change ideas identified. 3 to >2.0 pts . Key Driver Diagram mostly complete with some primary and secondary drivers and change ideas identified. 2 to >0 pts . Key Driver Diagram inadequately completed with minimal drivers or change ideas identified. 4 pts This criterion is linked to a Learning OutcomeMeasures and changes / interventions 5 to >4.0 pts . Fully describes how the PDSA was used to implement the change, including key stakeholder identification and involvement. 4 to >2.0 pts .Partially Partially describes how the PDSA was used to implement the change, including key stakeholder identification and involvement. 2 to >0 pts Incomplete Incomplete description of how the PDSA was used to implement the change, including key stakeholder identification and involvement. 5 pts This criterion is linked to a Learning OutcomeDiscuss results and include an annotated run chart 6 to >5.0 pts Full Marks Data collection to support the possible change is complete with an annotated run chart with run chart rules identified, x- and y-axes labeled, chart title, median, goal/target line placed. 5 to >2.0 pts Partially Data collection to support the possible change is mostly complete. The annotated run chart may be missing some elements. 2 to >0 pts Incomplete Data collection to support the possible change is incomplete. The run chart is incomplete of the required elements. 6 pts This criterion is linked to a Learning OutcomeEvaluation and next steps 3 to >2.0 pts . Completely evaluates the project. Adequately describes the plan for next steps and what would be needed for sustainability of the improvement. 2 to >1.0 pts . Partially evaluates the project. Mostly describes the plan for next steps and what would be needed for sustainability of the improvement. 1 to >0 pts . Inadequately evaluates the project. Incompletely describes the plan for next steps and what would be needed for sustainability of the improvement. 3 pts This criterion is linked to a Learning OutcomeAPA 2 pts . Reference page with APA formatting and correct grammar. Submitted on time. Follows page limit for document. 1 pts . Reference page with some APA formatting and grammar concerns. Submitted on time. 0 pts No Marks APA formatting and grammar unacceptable. Submitted late. 2 pts This criterion is linked to a Learning OutcomePDSA Worksheet 2 pts Full Marks PDSA Worksheet thoroughly completed and submitted on time. 1 pts Partially PDSA Worksheet mostly complete and/or not submitted on time. 0 pts No Marks PDSA Worksheet inadequately completed and/or not submitted on time. 2 pts Total Points: 25 Primary Drivers Change Ideas Secondary Drivers Review of number dips used in the previous week and documenting it By reducing the number of dips Calculating the number of hours, the retainer was worn Cleaning the retainers and applying again before bed time. Reducing the number of tobacco dips per week to achieve the SMART goal. By start wearing the retainers everyday for specified time SMART Aim To reduce the usage of smokeless tobacco dip using the Byte retainers to cope with recurring urges By keeping the retainers on at night Quit the tobacco usage at night Diverting by counting to 20, talking to a friend or exercise or any other activity By diverting myself doing some other activities By keep reducing the use of tobacco dips every week. Increasing the time of wearing retainers Stick to the 13-week treatment plan Reduce the urge of chewing tobacco on the removal of retainers Global Aim By reducing the number of dips to three dips per day in the first week and reducing the numbers by 1 every upcoming week To quit the use of smokeless tobacco dip by August 7th, 2022. Increasing the wearing time and reaching 22 hours by week 7 and maintaining it till week 13 During my 9 year tenure in the United States Army as a Senior Medic (out of all things because I know how bad of an issue/problem this is), I picked up a very bad habit of smokeless tobacco (dip). I started in early 2012 and I would say I almost over enjoyed it simply because it turned into a stress reliever and a very bad habit. As years went on, I never truly considered quitting or even easing off of it because of how highly addicted I was to this terrible habit. Over the years, I developed gum recession and borderline dependency. I have attempted to "quit" on numerous occasions but never really wanted to commit to it but wanted to quit due to the long-term and short-term effects that smokeless tobacco can have on an individual. I simply did not want to quit. As of recent, before trying alternatives like everyone else does, I knew that wouldn't stop my addiction so I took a route that will not only help me quit while changing something to my appearance but at a cost. Never truly had bad smile but I decided to engage in utilizing a form of Invisalign called Byte. There were two plans that I could do, one being lengthier than the other. One consisted of only wearing the retainers at night and the other for 22 plus hours a day. I chose the 22 hours a day method for a reason. While using these retainers, obviously you have to take them out to eat (which I wouldn't be surprised if some do not) but it is quite the process when it comes to eating, taking the retainers out, brushing, flossing, and putting them back in, and if you want to abide by the procedure set forth for the amount of money being spent, you should do it the proper way.  Now imagine using smokeless tobacco (dip) and considering the amount of my use (which is/was very heavy), going through that procedure numerous times a day to ensure my treatment plan was properly followed. I just began this process on Monday with under a 13 week treatment plan. As Monday, I have only had 6 sessions of using smokeless tobacco whereas I had used at least that amount per day.  Problem: Smokeless Tobacco (dip); Solution/Plan: Byte teeth straightening/whitening retainers.  This is a simple post of how my initial SMART Goal looked as it was pulled from the previous discussion during the identification of the problem: The Specifics would be me quitting tobacco usage and staying true to my Byte retained plan. The steps for this are more based around self-discipline than anything. For the Measurables I would have to say that my intended Byte plan is finished Sept 2022, that is already measured with set timeframes for each retained weekly. For the tobacco usage, I have set a goal for the next several weeks to lower my usage (this past week, no more than 4 dip sessions per day for two weeks in which I was actually lower than that). As the weeks go on, the usage will continue to decrease. These are achievable goals based on my measurables. Just takes discipline as stated. The Relevancy of this goal is obviously needing to stop my tobacco usage so my health stays in check. The straighter and whiter smile are just a plus. For Time, I did not set this quite yet to have quit because I needed to see how my mind would react to slowing down so drastically. I believe that in the next several weeks I will have a good gauge on when that time will be set.  I also included some initial baseline data in my original post regarding my tobacco usage which strongly correlates to how many hours a day my Byte retainers are in as well as food intake. I initially began this baseline data the day I started wearing my retainers (Monday, June 20th, 2022). The key goal is to obviously stay on track with my treatment plan but to reduce the intake of tobacco usage. The first week my goal was to have no more than three sessions of dip per day. I hate sharing this but I also had bad usage right before bed and that was key for my to completely cut out as my first step. I excelled with keeping my dip usage down to three a day and have completely cut out all nightly tobacco use as of Tuesday evening (June 21st, 2022). The goal for this week was to limit down to two tobacco sessions per day. As of now, I have kept the normal rate of last week. I have correlated this to the times I remove the retainers to eat a meal or snack. While the retainers are out, I have the strong urge to use tobacco since my teeth are already "dirty" and I will need to brush them again before reapplying my retainers on my teeth.  The goal for next week is to accomplish only 2 dips per day and wear my retainers over 16 hours per day. This is a 13 piece process over the
Answered 7 days AfterJul 23, 2022

Answer To: Submit your final paper on your personal or professional quality improvement project. This project...

Dr. Sulabh answered on Jul 30 2022
87 Votes
QUALITY IMPROVEMENT PROGRAM 4
Name of the Student
Name of the College or University
Name of the Course
Date
Introduction    
Title: Quality Improvement Program for improving teeth health with the use of aligners to restrict the intake of smokeless tobacco products
Identification of the problem
           The patient is suffering from the excessive intake of smokeless tobacco causing harm to his health. He has been serving in the American Army for the last 9 years. This patient is suffering from a recess
ion of his gums and borderline personality problem. Later he started suffering from teeth alignment problems as a side effect of the intake of excessive amounts of smokeless tobacco in his mouth. He decided to wear teeth aligners to keep his teeth in the proper orientation and proper shape. Further, his SMART goals include a reduction in the intake of smokeless tobacco dips from 4 dips a day to two dips and finally to 1 dip per day. He decided to wear the teeth aligners which day with the removal of the aligners only while brushing and while eating food. The planning was carried out for days spanning 3 weeks to limit the intake of tobacco dips in the mouth. After wearing the teeth aligners consecutively for several hours, the urge for the intake tobacco got significantly reduced and the teeth alignment with orientation improved significantly in this patient.
Background / Literature search
           There is a different distribution of nicotine in different cigarette brands. One option is to change and alter different cigarette brands. After changing and altering different cigarette brands there is much lesser exposure to cigarette smoke levels in people smoking cigarettes. The first two weeks of the experiment were kept at a baseline level. Various physiological parameters of the patients were measured after the intake of tobacco smoke. These parameters are changes in the heart rate, alterations in the blood pressure, the weight of the patients, and the amount of carbon monoxide in the blood and the lungs of the patients (Hatsukami et al., 2007). This statistical study involves the study of different factors like the ability to crave for cigarette smoking, the ability to withdraw the smoking of cigarettes, the ability to say no and quit smoking and deny the intake of smokeless tobacco dips. After the change over to the different smoking brands, there was a significant change in the nicotine and cotinine levels in the blood of the patients after some weeks of the intake of the smokeless tobacco (Hatsukami et al., 2007). Further, there is a decrease in the incidence and the occurrence of cancer in patients who restrict their intake of smokeless tobacco dips. Starting from the first week until the eighth week and finally, till the twelfth week of study, there was a significant reduction in the amount and the number of smokeless tobacco dips among the participants (Hatsukami et al., 2007). 
In a study conducted by Ogden et al., 2015 reported a significant reduction in the presence of harmful products after tobacco smoking among the patients in comparison to the results obtained in the baseline studies undergoing this statistical experimental study. The sample study involved the collection and analysis of the blood and urine samples of the participating patients in the study before and after exposure to cigarette smoke (Ogden et al., 2015). Various carcinogenic compounds are present in the blood and the urine samples of the patients undergoing the test analysis for the participants who inhaled cigarette smoke in comparison to the patients who did not smoke. 
Some of the carcinogenic compounds present in cigarette smoke are polycyclic hydrocarbons, aldehydes, nicotine, cotinine, and organic compounds like benzenes. These organic compounds and hydrocarbons accumulate in the lungs and the other tissues of the body causing serious damage to the body tissues (Ogden et al., 2015). There are different forms of cigarette smoking like the burning, heating of the tobacco in cigarettes, and inhalation of the tobacco smoke. According to the statistical study, there are serious harmful effects smoking of cigarettes leading to cancer and death of the body tissues due to necrosis. The levels of the carcinogenic products are much more in heating cigarettes after a few weeks of exposure in comparison to the other forms of cigarette smoking like the burning of cigarettes (Ogden et al., 2015). The level of carboxyhemoglobin was reduced in the number of participants as the weeks passed who decreased the intake of tobacco smoke due to the heating or burning of the cigarettes. The half-life of the different carcinogenic products present in the blood and urine are different so the concentration of these products varies in the body. In addition, the tar accumulation per day was observed in the normal participants and in the participants who were exposed to cigarette smoke (Ogden et al., 2015). 
Discussion
There are seriously harmful and side-effects of the intake of cigarette smoke like the activation of the sympathetic nervous system branch and an increase in the contraction rate of the heart muscles. Further, there is also an increase in the rate of the beating of the heart and an increase in the consumption of oxygen in the heart due to the fast contraction of the heart muscles. In addition, the polycyclic aromatic hydrocarbons present in cigarette smoke causes various side effects like inflammation of the body tissues, and a reduction in the supply of blood and nutrients to the heart muscles, and the different other organs of the body (NIH, 2014). 
There is clogging or hindrance of the flow of blood to the vessels leading to pain in the heart and a less supply of oxygen to the heart muscles (NIH, 2014). Smokeless tobacco is considered harmful as it causes addiction with a...
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