NURS 8302 Discussion: Quality Indicators
Discussion: Quality Indicators
As the doctoral of nursing practice (DNP) role continues to flourish. We will be looked upon to be leaders as change agents. There are many areas that will require adjustments and restructuring rather these changes are established in bedside care, informatic or policy and procedures. Having an advanced knowledge and skill set affords the DNP- prepared the ability to exponentially change the current health care systems, and patient outcomes through quality improvement and nurse-sensitive quality measures. The Agency of Healthcare and Research and Quality (AHRQ) defines quality indicators as “standardized evidence-based measures of health care quality that can be used with readily available hospital inpatient administrative data to measure and track clinical performance and outcomes” (pg.1). The purpose of trend and tracking health quality indicators can occur for several reasons and their values can be descriptive of warrant or unwarranted variation (Nash et al, 2019). The defining of the two will determine the focus of which type of improvement is required. Closing the gap between unwarranted variations has strongly relied on implementation research to establish and create effective quality improvement interventions (Shojania, 2004).
Cognizant of the role that training plays when it comes to improving a nurse’s competencies in EBP and thus empowering them to contribute to the development of EBP, here are certain strategies that can be undertaken from both an organizational level, to the larger professional level. At the organizational level, the organization can organize for opportunities where their nurses can get trained on evidence based practice. On the greater professional levels, professional bodies such as the ANA and the ANCC have developed certification program for nurses. By including components of evidence based practice in the certification exams, this ensures that nurses will prepare and apprise themselves on EBP and thus, in order to earn the certification, they will have to be competent in EBP. Alternatively, the institutions can include a whole different certification for EBP, where nurses will specifically be trained on EBP, tested on the same and thus, their competency will be proven by their certification. This will ultimately improve their ability to participate in the development and implementation of EBP.
Nurse sensitive indicators are distinct to nursing, and identify structure of care and process that directly affect patient care outcomes (OJIN, 2007). The two nurse quality indicators chosen are in regards to nurse burnout and quality of care. Research has shown that there is a direct correlation between the nurse burnout and patient care outcomes. Nurse burnout can be characterized as
a lack of energy that manifest in emotional inability to maintain objectiveness, emotional stability, increased frustration, and a lack of motivation; resulting in mistakes and poor patient care outcomes. Too often these nurses are met with disciplinary action for poor job performance, but the root cause if the problem is often missed. Implementation research has contributed to this process in the since that if a set of protocols or algorithms were not followed the nurse’s reprimand was warranted. The adaptation of the Human Err philosophies has opened the door for change in some setting. Eltaybani et al. (2021) concluded that staff nurse burnout is a significant determinant of quality care; future research should focus on small but feasible outcomes, as well as address the underlying root causes of the condition prior to staff burnout. Al-Qadi(2021) reflects a contributing factor to nurse burnout is the increased in workplace violence. In this article it attributes that nurse are directly affected by verbal, emotional, physical, violence that is bestowed upon not only by patients and/or family member, but also by supervisor that utilized intimidations tactics.
An organized rational change approach would be beneficial in the efforts to address effective patient and nurse centered outcomes. This approach brings awareness to the problem or quality gap, identifies the action to address the problem, focuses on implementation of action plan and institutes the change where all appropriate parties are involved.
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Reference:
Al-Qadi, M. M. (2021, January). Workplace violence in nursing: A concept analysis. Journal of occupational health. Retrieved September 10, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103077/.
Eltaybani, S., Yamamoto-Mitani, N., Ninomiya, A., & Igarashi, A. (2021). The association between nurses’ burnout and objective care quality indicators: A cross-sectional survey in long-term care wards. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00552-z
Nash, D. B., Joshi, M., Ransom, E. R., & Ransom, S. B. (2019). Variation in Medical Practice and Implication for Quality. In The healthcare quality book: Vision, strategy, and tools (pp. 75–101). essay, Washington, DC.
Polonsky, M. S. (2019). High-reliability organizations. Journal of Healthcare Management, 64(4), 213–221. https://doi.org/10.1097/jhm-d-19-00098
The national database of Nursing quality INDICATORS® (NDNQI®). (2007, September). Retrieved September 7, 2021, from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.aspx.
Quality improvement and monitoring at your fingertips. AHRQ. (n.d.). Retrieved September 8, 2021, from https://www.qualityindicators.ahrq.gov/.
Shojania, K. G. (2004, August). Toward a theoretic basis for quality improvement interventions. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 1: Series Overview and Methodology). Retrieved September 10, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK43917/.