Nursing Practice Essay Paper

Briefly describe the quality improvement practice gap you identified in your nursing practice or organization.

A significant quality improvement practice gap identified in the organization is high hospital readmission figures. The 30-day all cause hospital readmission figure at the facility is averaged at 15% readmission rate with the average readmission cost being $16,000. Admission for sickle cell anemia/trait accounts for the highest overall readmission rate at 37%, followed by septicemia at 10%, and heart failure at 5%. Highest average readmission cost is reported for complications of transplant tissues and organs at an average cost of $29,000. There is a difference between the reported readmission figures, and the figures that can be potentially obtained on the basis of current professional knowledge. The difference is attributable in part to a deficiency that could be addressed through nursing practice. Some of the causes of hospital readmission are inadequate discussion of care at home, hospital discharge being done early, infection, inadequate nutrition, failure to identify post-acute care needs, lack of timely follow-up care, medication errors, medication non-compliance by the patient, and fall injuries (Vana & Tazbir, 2021).  Nursing Practice Essay Paper

Develop at least two SMART objectives you might apply in the project planning phase or execution phase to address the quality improvement practice gap you identified.

Three SMART objectives have been identified for the quality improvement project targeting the hospital readmissions as a nursing practice gap.

First, create a nursing discharge education plan template (specific) that plans out what the discharged patient should watch out for over the next thirty days (measurable, attainable and time-bound) to improve care outcomes and reduce complications (relevant).

Second, adopt a home care management tool (specific) that organizes the home care requests for discharged patients (measurable and attainable) so that the nursing care team can streamline task assignment (relevant) within one day of receipt (time-bound).

Third, adopt a case review tool (specific) that is to be completed within 24 hours before discharge (time-bound) and organizes discharge instructions (measurable and attainable) so that patients are only discharged home when deemed medically appropriate to avoid early discharge (relevant).

Recommend at least two project management activities you would use for your project, addressing the quality improvement practice gap you identified. Explain your justification for why these activities would provide the best support.


Four project management activities will be adopted to address the quality improved practice gap identified. These activities are concrete actions that are well defined and practical, undertaken within the project to achieve the set SMART objectives. First, create and publish a nursing discharge education plan with a copy of the plan available to all nurses. The plan acts as a guide that ensures that the needs of patients after discharge from the hospital are met so that the patients function at an optimal level after they return home. Also, the discharge education plan will guide nurses in enabling patients to understand what is known about their condition, what was done to them in the hospital, the plan for treatment and follow-up while at home, and reasons to return to the hospital within a defined period of time after the discharge (Potter et al., 2022).

Second, prepare and publish a nurse administered home management care tool with scoring algorithms that is availed to nurses. This is a tool that enables the nurses to generate scores and associated risk levels to identify patients at risk of readmission as well as the care management services that they can benefit from while at home. Patients at high risk of readmission, such as elderly patients susceptible to falls or those who have undergone organ transplant surgery, can then be availed specialty nursing care services while at home to improve recovery and reduce readmission rates (Knapp & Olson, 2020).

Third, prepare and publish a case review tool that is administered by nurses. This is a tool that walks the nurses through details of a patient’s case, facilitates the collection and assessment of safety and quality data, and ensures that the patient is only discharged at the appropriate time after being adequately prepared for home care. This ensures that discharge is done at the appropriate time (not too early and not too late), and systems are in place for timely follow up care (Beauvais, 2018).


Beauvais, A. M. (2018). Leadership and Management Competence in Nursing Practice: Competencies, Skills, Decision-Making. Springer Publishing Company.

Knapp. K. R., & Olson, D. M. (2020). The Health Services Executive (HSE): Tools for Leading Long-Term Care and Senior Living Organizations. Springer Publishing Company.

Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A. (2022). Fundamentals of Nursing (11th ed.). Elsevier, Inc.

Vana, P. K., & Tazbir, J. (2021). Kelly Vana’s Nursing Leadership and Management (4th ed.). John Wiley & Sons Ltd.  Nursing Practice Essay Paper

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