Discussion: Quality Indicators Paper

Discussion: Quality Indicators Paper

There is no universal definition of quality care, considering different perspectives by patients, providers, and populations. As a result, it is essential to derive insights from various determinants of care quality, including process efficiency, care timeliness, patient satisfaction, and affordability, in response to the complexities surrounding the definition of quality in healthcare, the National Database of Nursing Quality Indicators (NDNQI) documents nursing-sensitive indicators consistent with the Donabedian’s structure, process, and outcome framework. Oner et al. (2020) define nursing-sensitive indicators (NSIs) as “the criteria for changes in health status that nursing care can directly affect” (p. 1006). NSIs provide valid and reliable tools for assessing care quality since they evaluate how nursing care processes and structures affect care outcomes. Examples of nursing-sensitive indicators are patient satisfaction and patient falls.

Guaranteeing patient satisfaction and preventing patient falls require nurses to embrace appropriate processes and utilize structures to improve outcomes. As a result, the two nursing-sensitive indicators obtain insights from various early nursing theories and philosophies that encourage nurses to apply knowledge, expertise, and skills in promoting care quality. Examples of nursing theories consistent with the determination to promote patient satisfaction and prevent falls are Flora Nightingale’s environmental theory and Katharine Kolcaba’s comfort theory. According to Avanecean et al. (2017), accidental falls and fall-related injuries affect patients physically, mentally, socially, and emotionally. Also, they increase care costs emanating from additional treatment due to fall injuries and prolonged hospitalization. On the other hand, patient satisfaction measures patient contentment with healthcare services. It consolidates various considerations, including how care services promote recovery, the perception of patient-centered care, elimination of suffering and pain, and the development of interpersonal relationships with care providers.

Florence Nightingale’s environmental theory is among early nursing grand theories whose impacts and influence cut across decades. This theory positions nurses at the forefront of preventing harm and improving care by modifying the environment to create optimal conditions for recovery (Avanecean et al., 2017). Nightingale’s environmental theory can influence nurse-led measures for preventing falls. For example, patients are susceptible to accidental falls due to environmental hazards, including poor lighting, spills, and flawed room arrangements. As a result, it is possible to prevent fall incidents by modifying the environment and creating optimal conditions that eliminate hazards and promote patient safety.

Equally, Kolcaba’s theory of comfort can provide the theoretical perspective of promoting patient satisfaction. According to Vo (2020), this theory bases patient comfort upon three significant concepts; relief, ease, and transcendence. Also, it accommodates four domains of comfort, including physical, psychospiritual, sociocultural, and environmental (Vo, 2020). Therefore, satisfactory care should provide patients with relief, ease their suffering and pain, and promote experiences that enable patients to overcome pain and suffering (transcendence). In the same breath, nurses should satisfy patients’ physical, psychospiritual, sociocultural, and environmental needs to achieve the acceptable thresholds for satisfactory care.

The two nursing-sensitive indicators and the subsequent insights from Nightingale’s environmental theory and Kolcaba’s comfort theory can influence my practice setting by placing me at the forefront of understanding factors that affect patients and modifying aspects that facilitate sentinel events and compromise patient satisfaction. By comprehending the need to prevent falls and guarantee patient satisfaction, it is possible to adjust the environment and incorporate all the domains for quality care, including physical, psychospiritual, sociocultural, and environmental. As a result, I must demonstrate knowledge and awareness of these concepts to provide quality care that guarantees patient satisfaction and safety.

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References

Avanecean, D., Calliste, D., Contreras, T., Lim, Y., & Fitzpatrick, A. (2017). Effectiveness of patient-centered interventions on falls in the acute care setting compared to usual care. JBI Database of Systematic Reviews and Implementation Reports, 15(12), 3006–3048. https://doi.org/10.11124/jbisrir-2016-003331

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2020). Nursing‐sensitive indicators for nursing care: A systematic review (1997–2017). Nursing Open, 8(3). https://doi.org/10.1002/nop2.654

Vo, T. (2020). A practical guide for frontline workers during COVID-19: Kolcaba’s comfort theory. Journal of Patient Experience, 7(5), 635–639. https://doi.org/10.1177/2374373520968392

 

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)

 

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.

Photo Credit: Coloures-Pic / Adobe

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.

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.

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

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What’s Coming Up in Module 2?

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.—

Excellent

90–100 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.

Good

80–89 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.

Fair

70–79 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.

Poor

: 0–69 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—

Excellent

90–100 6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Good

80–89 5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Fair

70–79 4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Poor

: 0–69 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—

Excellent

90–100 9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

Good

80–89 8 (8%) – 8 (8%)

Meets requirements for full participation.

Posts main Discussion by due date.

Fair

70–79 7 (7%) – 7 (7%)

Posts main Discussion by due date.

Poor

: 0–69 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.—

Excellent

90–100 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.

Good

80–89 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Fair

70–79 7 (7%) – 7 (7%)

Response is on topic and may have some depth.

Poor

: 0–69 0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

First Response:
Writing—

Excellent

90–100 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.

Good

80–89 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.

Fair

70–79 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.

Poor

: 0–69 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

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First Response:
Timely and full participation—

Excellent

90–100 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Good

80–89 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Fair

70–79 3 (3%) – 3 (3%)

Posts by due date.

Poor

: 0–69 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.—

Excellent

90–100 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.

Good

80–89 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Fair

70–79 7 (7%) – 7 (7%)

Response is on topic and may have some depth.

Poor

: 0–69 0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

Second Response:
Writing—

Excellent

90–100 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.

Good

80–89 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.

Fair

70–79 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.

Poor

: 0–69 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—

Excellent

90–100 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Good

80–89 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Fair

70–79 3 (3%) – 3 (3%)

Posts by due date.

Poor

: 0–69 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name: NURS_8302_Week2_Discussion_Rubric

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Learning resources:

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)

 

https://www.ahrq.gov/topics/quality-indicators-qis.html

https://www.facs.org/quality-programs/acs-nsqip?

https://www.nursingworld.org/practice-policy/health-policy/health-system-reform/quality/

https://www.qualityforum.org/Home.aspx

https://openathens.ovid.com/OAKeystone/deeplink?idpselect=https://idp.waldenu.edu/openathens&entityID=https://idp.waldenu.edu/openathens&T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00115514-201908000-00005&D=ovft&PDF=y