NURS 8302 Discussion Quality Indicators

NURS 8302 Discussion Quality Indicators

Walden University NURS 8302 Discussion Quality Indicators-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University NURS 8302 Discussion Quality Indicators assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NURS 8302 Discussion Quality Indicators

 

Whether one passes or fails an academic assignment such as the Walden University NURS 8302 Discussion Quality Indicators depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for NURS 8302 Discussion Quality Indicators

The introduction for the Walden University NURS 8302 Discussion Quality Indicators is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for NURS 8302 Discussion Quality Indicators

 

After the introduction, move into the main part of the NURS 8302 Discussion Quality Indicators assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for NURS 8302 Discussion Quality Indicators

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for NURS 8302 Discussion Quality Indicators

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8302 Discussion Quality Indicators

Quality improvement in nursing is the systematic approach that is guided by data to improve the quality and safety of healthcare delivery. Quality indicators are measures of health care quality that use readily available hospital inpatient administrative data. They are both used to highlight potential quality concerns, identify areas that need further study and investigation and monitor these changes over a period of time. The American Nurses association encourages nurses to improve patient outcomes, through continuing education on nursing quality.

Nursing theories are composed of knowledge that helped to define what we know as nursing today. Nursing theories provided a way to define nursing as a unique discipline as a profession. This helped to establish a foundation for nursing knowledge, help to identify and develop what we know now as standard of care. Quality indicators (QI) provides a measure that could be used to monitor performance over time.

My chosen QIs were related to patient safety and prevention of adverse events. This will include perioperative pulmonary embolism or Deep vein thrombosis rates and postoperative sepsis rates. Working in women’s health and an OB/GYN practice, this particular population is at an increased risk for developing PE or DVTs. The first article by Pather at el., found that thromboembolism is the most important cause of maternal mortality in the developed world. Implementing a surgical protocol where heparin is administered twice a day for the first 24 hours, was shown to significantly decrease rates of PE. The second article by Hodgetts Morton et al, found that worldwide Caesarean section delivery is the most common major operation. Sepsis and post-natal infection accounts for significant maternal mortality or morbidity ( Hodgetts Morton, 2018). They found that implementing a chlorhexidine vaginal preparation versus standard cleansing protocol had a significant reduction in the postpartum rates or readmission due to sepsis/ endometritis.

Reference

Hodgetts Morton, V., Wilson, A., Hewitt, C., Weckesser, A., Farmer, N., Lissauer, D., Hardy, P., & Morris, R. K. (2018). Chlorhexidine vaginal preparation versus standard treatment at caesarean section to reduce endometritis and prevent sepsis—a feasibility study protocol (the preps trial). Pilot and Feasibility Studies, 4(1). Retrieved September 8, 2021, from https://doi.org/10.1186/s40814-018-0273-9

Pather, S., Sykes, P., Davis, R., Reid, R., & Skjellerup, N. (2017). Thromboprophylaxis following caesarean section; hospital protocols are necessary. New Zealand Medical Journal, 114(1136), 339-340. Retrieved from https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscho

Florence Nightingale pioneered research in nursing, and since then, a focus on improving patient care has remained 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 aspects of healthcare in which patients are directly impacted by nurses’ care.

What exactly are nursing-sensitive indicators? What aspects of a patient’s care are directly influenced by nurses’ roles and methods of care delivery? For a future DNP-prepared nurse, how might these nurse-sensitive indicators change healthcare delivery and the nursing profession?

In this Discussion, you will examine your understanding of nurse-sensitive quality indicators by reflecting on those quality indicators that may be most relevant to your practice setting. You will conduct a literature search for articles that address these quality indicators and reflect on the connections between 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.

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.

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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

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

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

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Sample Answer 2 for NURS 8302 Discussion Quality Indicators

Quality of care is measured by the degree in which services rendered achieve desired health outcomes (Quality of Care, 2021).  Nursing has been at the forefront of health care quality and patient safety for many years.  Nurse-sensitive indicators (NSI) are measurable patient related outcomes that are directly affected by nursing care (Burston, Chaboyer, & Gillespie, 2014).  When considering which NSI’s to measure to be effective the DNP-prepared nurse must carefully select NSI’s relative to the clinical context, identify how the NSI data will be reported and used, and consider how the NSI will be embedded into clinical practice (Burston et al., 2014).  Two specific NSI’s are patient falls and pressure ulcer prevention (Montalvo, 2007).

According to Burston, et al. (2014), studies show patient outcomes are affected by both nursing structural and process variables.  Structural variable include nurse-to-patient ratios, nursing hours per patient day, nursing education level, and nursing experience (Burston, et al., 2014).  Process variables include specific nursing interventions provided and process care delivery (Burston, et al., 2014).  Burston, et al., (2014) cautioned that data collection and analyzation approaches can cause inconsistencies.  For example, analysis at the hospital level does not allow for shift-to-shift variations that would be better identified at the unit level (Burston, et al., 2014).  The DNP-prepared nurse must analyze data and consider both structural and process variables to develop process changes at the unit level and organization level to improve quality.

Pressure injuries (PIs) are defined as an insult to the skin and underlying soft tissue usually over a bony prominence that may cause and open wound and cause pain (Hoedl, Eglseer, & Lohrmann, 2019).  Hospital acquired PI prevalence rates in the United States range from 1.4% to as high as 49% (Hoedl, et al., 2019). One quality model utilized to evaluate PI prevention is the Donabedian Model of Healthcare Organizations. It is composed of three quality indicators: structure, process, and outcomes. According to Hoedl, et al. (2019), a systematic mapping review using the Donabedian Model identified 146 quality indicators for PI prevention and care, noting 17.6% were structural-level indicators, 48.6% process-level indicators, and 33.6% were outcome-level indicators.  The researchers utilized the Nursing Quality Measurement 2.0 Survey to further identify specific structure, process, and outcome indicators that could be addressed in the quality improvement project to improve PI injury prevention and care (Hoedl, et al., 2019).  These measures could be utilized by the DNP-prepared nurse to address local quality improvement initiatives for PI prevention and care.

Patient falls are a common cause of patient injury during hospitalizations. Morgan, Flynn, Robertson, New, Forde-Johnston, & McCulloch (2017), discussed a staff-led quality improvement intervention which consisted of engagement and communication activities, teamwork and systems improvement training, support and coaching and iterative Plan-Do-Check-Act cycles in an effort to decrease falls.  Intentional rounding was implemented and evaluated using process (hourly rounding by staff) and outcome (patient falls).  There was 50% reduction in falls noted on the units and researchers concluded that integrating teamwork training and staff-led systems redesign resulted in effective change and improvement (Morgan, et al., 2017).  The DNP-prepared nurse is uniquely aligned as a nurse leader and educator to foster staff-led quality improvement initiatives in the clinical setting.

 

References

Burston, S., Chaboyer, W., & Gillespie, B. (2014). Nurse sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues. Journal of Clinical Nursing, 23(13-14), 1785–1795. https://doi.org/ezp.waldenulibrary.org/10.1111/jocn.12337

Hoedl, M., Eglseer, D., & Lohrmann, C. (2019). Structure, process, and quality indicators for pressure injury prevention and care in Austrian hospitals: A quality improvement project. Journal of Wound, Ostomy, and Continence Nursing, 46(6), 479–484. https://doi.org/10.1097/WON.0000000000000586

Montalvo, I. (2007). The National Database of Nursing Quality Indicators. The Online Journal of Issues in Nursing, 12(3), Article 2. https://doi.org/10.3912/OJIN.Vol12No03Man02

Morgan, L., Flynn, L., Robertson, E., New, S., Forde-Johnston, C., & McCulloch, P. (2017). Intentional rounding: a staff-led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1-2), 115–124. https://doi.org/ezp.waldenulibrary.org/10.1111/jocn.13401

Quality of care. (2021). World Health Organization. Retrieved September 5, 2021, from https://www.who.int/health-topics/quality-of-care#tab=tab_1

Sample Answer 3 for NURS 8302 Discussion Quality Indicators

Thank you for your post. Your post is fascinating, and I learn much from it. As you have noted, injuries to the skin and other underlying tissues brought on by prolonged pressure on the skin are referred to as pressure ulcers, bedsores, or pressure sores. Pressure ulcer rates are a measure, analysis, and assessment of the incidence and prevalence of pressure ulcers among patients that are relevant to nurses. According to Kleinpell et al. (2019), this quality indicator is crucial since it shows how well nurse prevention works to prevent and treat pressure ulcers.As you have seen, another crucial nurse-sensitive quality measure is patient falls with injury rates. This metric aids in the assessment of the quantity of patient falls that cause injuries. According to Spano-Szekely et al. (2019), this quality indicator is crucial because it shows how well nurse prevents and manages falls and safety precautions. You have accurately analyzed how early ideas and theories of quality improvement influenced the creation of the aforementioned quality indicators. TQM (Total Quality Management), as you have noted, places a strong emphasis on the value of cooperation, teamwork, and continual quality improvement. According to this idea, nurse-sensitive indicators have been created by highlighting the importance of nurses in providing the best care possible as well as ongoing observation and enhancement of healthcare results (Xu, Kane & Arling, 2019). Donobedian’s quality model, which emphasizes the value of evaluating process and outcome indicators to evaluate and enhance the quality of care, is also crucial for the creation of nurse-sensitive quality indicators.You have also given careful consideration to how these quality indicators may affect your nursing practice in your analysis. You will be in a better position to evaluate the efficacy of interventions, implement fall prevention measures, implement pressure ulcer prevention strategies, encourage collaborative care, and promote ongoing quality improvement in the healthcare industry if you rely on these quality indicators (Kleinpell et al., 2019).

References

Kleinpell, R., Blot, S., Boulanger, C., Fulbrook, P., & Blackwood, B. (2019). International

critical care nursing considerations and quality indicators for the 2017 surviving

sepsis campaign guidelines. Intensive care medicine,45, 1663-1666.

Spano-Szekely, L., Winkler, A., Waters, C., Dealmeida, S., Brandt, K., Williamson, M., … &

Wright, F. (2019). Individualized fall prevention program in an acute care setting: an

evidence-based practice improvement. Journal of nursing care quality,34(2), 127-132.

Xu, D., Kane, R., & Arling, G. (2019). Relationship between nursing home quality indicators

and potentially preventable hospitalization.BMJ quality & safety, 28(7), 524-533

Sample Answer 4 for NURS 8302 Discussion Quality Indicators

Florence Nightingale introduced research to the nursing field, and research has continued to be at the forefront of nursing practice.  Nurse-sensitive indicators are influenced by nursing care, including patient falls, hospital-acquired pressure ulcers, catheter-associated urinary tract infections (CAUTI), and central line associated blood stream infections (CLABSI).  This discussion will tackle patient falls and hospital-acquired pressure injuries.

Fall prevention is a system and study of strategies for preventing accidental falls by older people.  Falls are not only more common in older adults than the general population, older adults also have more severe implications like osteoporosis (Kte, 2023).  When older adults fall, any injury can be considered more serious than it would have been due to longer healing time, weaker immune system, etc.  Heightened risk for fall include gait abnormalities, balance problems, impaired vision and cognition, and a previous history of fall.

Morse Fall Scale is what can be used to assess fall risk.  As of 2017, the assessment consists of six risk factors: history of falling, secondary diagnosis, ambulatory aid, IV, gait, and mental status (Kte, 2023).  There are several strategies for fall prevention.  Older adults should list all the prescription and over-the-counter (OTC) medications and then review the list with their doctor so they can go over side effects and possible interactions.  Handrails and grab bars could be installed in bathrooms and stairs.  Nonslip mats can be added to bathtubs and showers.  Good lighting can help patients with degrading vision.  Patients can receive walkers, canes, non-slip socks, and more.

Another nurse-sensitive indicator is hospital-acquired pressure injuries (HAPI); HAPIs seriously affect patients’ prognosis and quality of life (Zhou et al., 2023).  Pressure injuries are enduring complications of hospitalization.  The initial assessment or upon transfer with Braden Scale score is vital in preventing pressure injuries (Fulbrook & Lovegrove, 2023).  Turn team, which should come around every two hours while in bed and every 15-20 minutes in chair, should be implemented.  Incontinence management or toileting should be scheduled.  Check on the patients during turn team to see if they need to be changed.

References:

Fulbrook, P., & Lovegrove, J. (2023). Reporting accuracy of pressure injury categorisation in an acute tertiary hospital: A four‐year analysis. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 32(17/18), 6403–6414. https://doi.org/10.1111/jocn.16662

Kte, pi, B. M. (2023). Fall prevention. Salem Press Encyclopedia of Health.

Zhou, Y., Yang, X., Ma, S., Yuan, Y., & Yan, M. (2023). A systematic review of predictive models for hospital-acquired pressure injury using machine learning. Nursing open, 10(3), 1234–1246. https://doi.org/10.1002/nop2.1429Links to an external site.

Content

Name: NURS_8302_Week2_Discussion_Rubric

• Grid View
• List View

		Excellent 90–100	Good 80–89	Fair 70–79	Poor : 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.		Points Range: 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	Points Range: 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	Points Range: 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	Points Range: 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing		Points Range: 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	Points Range: 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	Points Range: 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation		Points Range: 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	Points Range: 8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date.	Points Range: 7 (7%) – 7 (7%) Posts main Discussion by due date.	Points Range: 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.		Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	Points Range: 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	Points Range: 7 (7%) – 7 (7%) Response is on topic and may have some depth.	Points Range: 0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
First Response: Writing		Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	Points Range: 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	Points Range: 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation		Points Range: 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	Points Range: 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	Points Range: 3 (3%) – 3 (3%) Posts by due date.	Points Range: 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.		Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	Points Range: 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	Points Range: 7 (7%) – 7 (7%) Response is on topic and may have some depth.	Points Range: 0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
Second Response: Writing		Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	Points Range: 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	Points Range: 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation		Points Range: 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	Points Range: 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	Points Range: 3 (3%) – 3 (3%) Posts by due date.	Points Range: 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Total Points: 100