Steps of Gap Analysis in Carries Case Study

Steps of Gap Analysis in Carries Case Study

Carrie is a registered nurse practicing in the facility for the last five months. Previously, Carrie has been admired by the majority of the healthcare staff due to her work dedication. She was always ready when on call not minding the time or season. However, I have recently observed some unusual behaviors in her, where she is always reserved with less socializing with colleagues which are the norm of the facility. Her behavior is also questionable due to her long hours in lunch breaks and restroom breaks. All this have affected her performance recently. 

After a Quality Improvement meeting, some issues were identified. There were 5% more medical errors as well as more drug wastage as compared to the past 12 months. This calls for the need to carry out a gap analysis and action plan. Three steps will be followed in the preparation of the analysis and plan. The procedure will involve identification of current happenings in healthcare personnel, the definition of Best Practices and determination of the purpose of the activity so as to develop learning objectives.  

Step 1: Conducting Need Assessment

The step involves identifying/clarifying of the current happenings with the healthcare personnel in op floor. Working from 7 pm to 7 am work shift, working on extra hours, holiday and weekends are causing tiredness and fatigue to the employees. Carrie one of the RN has recently adopted a weird behavior. Recently it has been noted that she takes a lot of time during restroom breaks and is always late from meal breaks. 

While working with her, I have observed that she is always occupied with other businesses that are not medically related. She is reserved with her details and has little to share with her colleagues. The situation has reached the extent of Carrie leaving her patients to the care of her colleagues. The recent statistic after the Quality Improvement meetings illustrates an increase in medical errors by 5% and more drug wastage in the last 12 months. There is a close relationship between nurses’ fatigue and patient safety, and this may be the cause of errors indicated during Quality Improvement.

Step 2: Definition of Best Practices or “Gold Standard.”

This step involves identification of what is required for the nurses at the health facility. BCNU (2015) explains that when registered nurses’ works for more than 12.5 hours, the likelihood of adverse event occurrence increases by three times. It is the responsibility of every RN to reduce medical errors in their practice. This is achieved by use of information technology-based approaches, the system approaches, and system approaches (Ioannidis, & Lau, 2001). The RNs should be efficient in the providence of service to customers to reduce medical errors and drug wastage. 

Step 3: Determination of Purpose Activity and Program Design and Objectives

To reduce overworking RNs, it is important to lessen the number of hours each nurse works during a particular shift. There should be fewer calls during holidays or while off duty. This will reduce fatigue which in turn reduces medical errors including drug wastage. Nurses should follow their defined duties whereby they support it from A-Z to ensure no errors after looking for assistance from their colleagues. Frequent internal training on quality improvement should be included where the nurses are reminded of the need for effective and efficient patient care. It is important for every caregiver to put te interest of patients as their role is patient-centred. 


BCNU. (2015). BCNU Position Statement on NURSING WORKLOAD and PATIENT SAFETY. BC Nurses Union. Retrieved from

Ioannidis, J., & Lau, J. (2001). Evidence on interventions to reduce medical errors. Journal Of General Internal Medicine, 16(5), 325-334.

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