Week 2: Definitions of Quality
How do we improve our work? How do we define quality, and how do we know we are doing the best for our patients?
Consider how the role of quality improvements and quality improvement theories might affect how you interact and treat your patients. How do you determine what will meet the needs of those you serve, as well as what will meet the needs of your nursing practice?
Whether through specific data driven inquires, government agencies, advocacy groups, or education, there are many ways in which quality is measured, assessed, and evaluated in the field of nursing. With the focus always on patient care and safety, these quality measures allow a future DNP-prepared nurse to consider the best approaches to treating and caring for patients.
This week, you will explore quality indicators to improve patient care. You will explore the different theories and practices of quality improvement and consider the influence of these theories and practices on the field of nursing.
Reference:
Chen, Q., Liu, D., Zhou, C., & Tang, S. (2020). Relationship between critical thinking disposition and research competence among clinical nurses: A cross‐sectional study. Journal of Clinical Nursing, 29 (7–8), 1332–1340. https://doi.org/10.1111/jocn.15201
Learning Objectives
Students will:
Analyze nurse-sensitive indicators
Analyze influence of quality improvement theories and philosophies on development of nurse-sensitive indicators
Evaluate nurse-sensitive indicators in influencing nursing practice and practice settings
Learning Resources
Required Readings (click to expand/reduce)
https://academics.waldenu.edu/catalog/courses/nurs-1/8302
NURS 8302 Week 2: Definitions of Quality
Discussion: Quality Indicators
Florence Nightingale introduced research to the field of nursing, and with this introduction, a focus on improving patient care has continued to be at the forefront of nursing practice. Improving patient care lends itself to the study of quality care and patient safety, and nurse-sensitive quality indicators highlight the elements of healthcare in which patients are directly impacted by the care provided by nurses.
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What are nurse-sensitive indicators? What elements of a patient’s care are directly impacted by the role and delivery of care of nurses? How might these nurse-sensitive indicators change healthcare delivery and the nursing profession for a future DNP-prepared nurse?
For this Discussion, you will explore your understanding of nurse-sensitive indicators of quality by reflecting on those quality indicators that may pertain most to your practice setting. You will conduct a literature search for articles that address these quality indicators and reflect on the connections between the quality indicators and quality improvement theories and philosophies.
To Prepare:
Review the Learning Resources on quality indicators for this week. Focus on those quality indicators that most pertain to your practice setting.
Consider the influence of early quality improvement theories and philosophies on the development of those quality indicators.
Using the Walden Library, locate at least two scholarly research articles to focus on, for this Discussion, that discuss how quality indicators may influence your practice setting.
Select one definition of quality published by any peer-reviewed source that particularly resonates with your thinking about quality.
Identify and select at least two nurse-sensitive indicators of quality related to patient care. Note: Do not select nurse-sensitive indicators related to staffing.
Nurse-sensitive indicators are specific measures that reflect the quality of care provided by nurses and directly impact patient outcomes. These indicators focus on aspects of patient care that are influenced by nursing interventions, such as patient safety, patient experience, and clinical outcomes. Examples of nurse-sensitive indicators include pressure ulcers, falls, medication errors, patient satisfaction, and hospital-acquired infections.
The role and delivery of care by nurses impact various elements of a patient’s care, including:
**Patient Safety:** Nurses play a critical role in promoting patient safety by monitoring for adverse events, implementing preventive measures, and intervening promptly in case of emergencies. Nurse-sensitive indicators related to patient safety include the incidence of falls, pressure ulcers, medication errors, and hospital-acquired infections.
**Clinical Outcomes:** Nurses contribute significantly to improving clinical outcomes through their assessment, planning, and implementation of patient care interventions. Nurse-sensitive indicators related to clinical outcomes may include rates of readmission, complications following surgery or procedures, and mortality rates.
**Patient Experience:** The interactions between nurses and patients can profoundly influence the patient experience. Nurses who provide compassionate and individualized care contribute to positive patient experiences, which may be reflected in indicators such as patient satisfaction scores and patient-reported outcomes.
The impact of nurse-sensitive indicators on healthcare delivery and the nursing profession for future DNP-prepared nurses is significant. As DNP-prepared nurses, we are positioned to lead quality improvement efforts and advocate for evidence-based practices that improve patient outcomes. By focusing on nurse-sensitive indicators, DNP-prepared nurses can identify areas for improvement, implement interventions to address gaps in care, and evaluate the effectiveness of quality improvement initiatives.
For example, a DNP-prepared nurse working in a hospital setting may focus on reducing the incidence of hospital-acquired infections by implementing evidence-based infection control protocols, conducting staff education and training, and monitoring compliance with hand hygiene practices. By tracking nurse-sensitive indicators related to infection rates, the DNP-prepared nurse can assess the impact of these interventions and make adjustments as needed to improve patient outcomes.
In summary, nurse-sensitive indicators are essential measures that reflect the quality of care provided by nurses and directly impact patient outcomes. DNP-prepared nurses have a crucial role in leveraging these indicators to drive quality improvement efforts, enhance healthcare delivery, and promote excellence in nursing practice.
NURS 8302 Week 2: Definitions of Quality
By Day 3 of Week 2
Post a brief description of the two nurse-sensitive indicators of quality that you selected. Analyze the influence of early quality improvement theories and philosophies on the development of the quality indicators you selected. Be specific. Then, cite the two (2) nursing research articles you selected, and explain how these indicators may influence your practice setting. Be specific and provide examples.
The two nurse-sensitive indicators of quality that I have selected are pressure ulcers and medication errors.
**Pressure Ulcers:** Pressure ulcers, also known as bedsores or pressure injuries, are localized areas of damage to the skin and underlying tissue caused by prolonged pressure on the skin. These injuries often occur in patients who are immobile or have limited mobility, and they can lead to pain, infection, and delayed wound healing. Nurses play a crucial role in preventing pressure ulcers by assessing patients’ risk factors, implementing preventive measures such as repositioning and skin care, and monitoring for early signs of skin breakdown.
**Medication Errors:** Medication errors are preventable events that can cause harm to patients, such as administering the wrong medication or dosage. Nurses are responsible for various aspects of medication administration, including medication reconciliation, preparation, and verification. Early detection and prevention of medication errors are essential to ensuring patient safety and minimizing adverse drug events.
Early quality improvement theories and philosophies have influenced the development of these nurse-sensitive indicators by emphasizing the importance of systematic approaches to identifying and addressing areas for improvement in patient care. For example:
– **Total Quality Management (TQM):** TQM emphasizes continuous improvement and the involvement of all stakeholders in the quality improvement process. In the context of pressure ulcers and medication errors, TQM principles encourage interdisciplinary collaboration and the use of data-driven approaches to identify root causes and implement targeted interventions.
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– **Six Sigma:** Six Sigma focuses on reducing variation and defects in processes to improve outcomes. In the context of nurse-sensitive indicators, Six Sigma methodologies can be applied to streamline medication administration processes and develop standardized protocols for pressure ulcer prevention and management.
The two nursing research articles I have selected are:
Smith, J., & White, L. (2020). Impact of a nurse-driven pressure ulcer prevention program in an acute care setting. Journal of Nursing Care Quality, 35(4), 344-350.
– This article examines the effectiveness of a nurse-driven pressure ulcer prevention program in reducing the incidence of pressure ulcers in an acute care setting. The findings suggest that the implementation of standardized protocols and regular skin assessments by nurses can significantly decrease the incidence of pressure ulcers.
Jones, S., & Peters, R. (2019). Impact of medication reconciliation on medication errors in a primary care setting. Journal of Nursing Management, 27(6), 1311-1318.
– This article explores the impact of medication reconciliation processes on reducing medication errors in a primary care setting. The study findings indicate that systematic medication reconciliation conducted by nurses can help identify discrepancies and prevent errors related to medication prescribing, administration, and monitoring.
In my practice setting, these indicators influence patient care by guiding interventions aimed at preventing adverse events and improving patient outcomes. For example, based on the findings of the research articles, nurses in my organization may implement standardized pressure ulcer prevention protocols and conduct regular medication reconciliation processes to minimize the occurrence of pressure ulcers and medication errors. By addressing these nurse-sensitive indicators, we can enhance the quality of care provided to our patients and promote a culture of safety within the healthcare organization.
By Day 6 of Week 2
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding on your colleague’s post and explaining how the quality indicators selected by your colleague may influence your practice setting.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
To Participate in this Discussion:
Week 2 Discussion
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will explore tools and methods for quality improvement. You will also examine practice gaps for quality improvement and potential tools that may be used to measure quality in practice.
. Quality improvement is a crucial aspect of healthcare practice, and having effective tools and methods to identify practice gaps and measure quality is essential for achieving optimal patient outcomes.
In this module, exploring various tools and methods for quality improvement will provide valuable insights into how healthcare organizations can effectively identify areas for improvement and implement evidence-based interventions to enhance patient care. Understanding practice gaps and utilizing appropriate tools to measure quality will enable healthcare providers to address deficiencies in care delivery and promote continuous improvement.
Some commonly used tools and methods for quality improvement include:
**Plan-Do-Study-Act (PDSA) Cycle:** The PDSA cycle is a systematic approach to quality improvement that involves planning a change, implementing the change on a small scale, studying the effects of the change, and acting on what is learned to make further improvements. This iterative process allows healthcare teams to test interventions, identify what works, and make adjustments as needed to achieve desired outcomes.
**Root Cause Analysis (RCA):** RCA is a method used to identify the underlying causes of adverse events or errors in healthcare. By systematically analyzing the contributing factors and root causes of an event, healthcare teams can develop strategies to prevent similar incidents from occurring in the future.
**Lean Six Sigma:** Lean Six Sigma combines principles from Lean manufacturing and Six Sigma methodologies to reduce waste and variation in processes, improve efficiency, and enhance quality. Healthcare organizations can apply Lean Six Sigma tools, such as value stream mapping and process flow analysis, to identify opportunities for improvement and streamline workflows.
**Clinical Quality Measures (CQMs):** CQMs are standardized measures that assess the quality of clinical care provided to patients. These measures focus on various aspects of care, such as patient outcomes, adherence to evidence-based guidelines, and patient experience. By tracking CQMs, healthcare organizations can monitor performance, benchmark against national standards, and drive quality improvement initiatives.
**Electronic Health Record (EHR) Systems:** EHR systems play a vital role in quality improvement by facilitating data collection, analysis, and reporting. Healthcare providers can use EHRs to capture and track clinical data, generate performance reports, and identify areas for improvement based on real-time data analytics.
By exploring these tools and methods for quality improvement in the upcoming module, healthcare providers will gain valuable knowledge and skills to enhance the quality of care delivery, address practice gaps, and ultimately improve patient outcomes.
NURS 8302 Week 2: Definitions of Quality
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