NURS 8302 WEEK 2 DISCUSSION POST
NURS 8302 WEEK 2 DISCUSSION POST
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.
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?
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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.
[elementor-template id="165244"]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.
Follow this instruction below to complete the assignment
Write 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.
LEARNING RESOURCES
Required Readings
Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.
Chapter 3, “Variation in Medical Practice and Implications for Quality” (pp. 75–101)
Chapter 7, “Health Information Technology in Healthcare Quality and Safety: Prevention, Identification, and Action” (pp. 189–211)
Agency for Healthcare Research and Quality. (n. d.). Topic: Quality indicatorsLinks to an external site.
(QIs). https://www.ahrq.gov/topics/quality-indicators-qis.html
American College of Surgeons. (2021). ACS National Surgical Quality Improvement ProgramLinks to an external site.
(ACS NSQIP). https://www.facs.org/quality-programs/acs-nsqip?
American Nurses Association. (n. d.). Nursing qualityLinks to an external site.
. https://www.nursingworld.org/practice-policy/health-policy/health-system-reform/quality/
Centers for Medicare and Medicaid Services. (2011). Quality of care centerLinks to an external site.
. https://www.cms.gov/Center/Special-Topic/Quality-of-Care-Center
National Quality ForumLinks to an external site.
. (2021). https://www.qualityforum.org/Home.aspx
Polonsky, M. (2019). High-reliability organizations: The next frontier in healthcare quality and safetyLinks to an external site.
. Journal of Healthcare Management, 64, 213-221. https://doi.org/10.1097/JHM-D-19-00098
The Leapfrog GroupLinks to an external site.
. (n. d.). https://www.leapfroggroup.org/
Vermont Oxford Network. (n. d.). Databases and reportingLinks to an external site.
. https://public.vtoxford.org/data-and-reports/
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NURS 8302 Week 2 Discussion
Nursing-sensitive indicators (NSIs) identify care structures and care processes that influence care outcomes. Two examples of nurse-sensitive quality indicators include Ventilator-associated pneumonia (VAP) and Pressure ulcers. VAP is one of the most common ICU-acquired infections. Reported incidences of VAP vary widely from 5 -40% depending on the clinical setting and diagnostic criteria. Pressure ulcers are a common patient safety concern and a major healthcare problem. Many hospitalized patients cannot ambulate and have poor nutrition, fragile skin, and complex disease processes, which increase the risk of developing pressure ulcers.
Early quality improvement theories and philosophies have influenced the development of NSIs like VAP and Pressure ulcers. They provide the essence of decision-making about patient care with diverse approaches in environment development, relationships, or a philosophical perspective (Almeida et al., 2020). For example, the behavioral systems theory by Dorothy Johnson describes man as a behavioral system that continually strives to maintain balance through adjustments and adaptations to his ever-changing internal and external environments. Thus, nurses should continually improve their quality of care to enable patients to adjust and adapt to the environment. This has led to the development of NSIs to evaluate the quality of care provided to patients.
Papazian et al. (2020) explain that VAP is linked to prolonged duration of mechanical ventilation and ICU hospitalization. Thus, monitoring the VAP indicator to determine the quality of care provided to ventilated patients is crucial. The indicator may influence my practice setting since providers will be obliged to identify measures to improve the quality of care in the ICU and lower the rates of VAP. Awoke et al. (2022) explain that pressure ulcer prevention is a key indicator in assessing quality care and patient experience. Nurses have a high responsibility in administering preventative care for pressure ulcers. The indicator can influence my practice setting by encouraging nurses to identify effective measures to reduce pressure injuries..
References
Almeida, Í. L., Ramos, N. M., Andrade, Í. R., Carvalho, R. E., Silva, L. F., KP, S., & Oliveira, S. J. (2022). Theories used by nurses to promote patient safety practices: A scoping review. Journal of Nursing Education and Practice, 12(7). https://doi.org/10.5430/jnep.v12n7p1
Awoke, N., Tekalign, T., Arba, A., & Lenjebo, T. L. (2022). Pressure injury prevention practice and associated factors among nurses at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia: a cross-sectional study. BMJ open, 12(3), e047687. https://doi.org/10.1136/bmjopen-2020-047687
Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Medicine, 46(5), 888-906. https://doi.org/10.1007/s00134-020-05980-0