NURS 8300 Week 2: Quality Indicators Discussion
NURS 8300 Week 2: Definitions of Quality
NURS 8300 Week 2: Quality Indicators Discussion
Quality Indicators Discussion
How do you define quality as it pertains to health care and the practice of nursing? Some nurses may define quality as effective interdisciplinary teamwork that results in better patient-health outcomes, while hospital administrators may define quality as appropriately delegated responsibilities, completion of tasks, and effective patient flow. Due to the subjective nature of the term, quality is a topic of great debate.
In an effort to define quality in health care, standards have been developed to establish consistency and provide guidance. The National Database of Nursing Quality Indicators (NDNQI) outlines nursing-sensitive indicators that encompass measurement scales for quality of nurse professionals as well as quality of the services provided by nurses to patients. In this week’s Discussion, you evaluate the determinants of quality,m based on the NDNQI indicators and the theoretical underpinnings of these quality indicators. You apply nursing-sensitive indicators to your current setting and assess how each definition of quality contributes to the idea of quality overall.
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To prepare for Quality Indicators Discussion:
Review the NDNQI indicators presented in the Learning Resources that emphasize quality. Focus on those indicators that 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 that discuss how quality indicators influence your practice setting.
Select one definition of quality published by any peer-reviewed source that particularly resonates with your thinking about quality.
By Day 3, post a cohesive scholarly response that addresses the following:
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Identify two nurse-sensitive indicators of quality that relate to patient care and analyze the influence of early quality improvement theories and philosophies on the development of those indicators. For this exercise, do not choose nurse sensitive indicators that relate to staffing levels.
Find and cite at least 2 nursing research articles you located and evaluate how these indicators influence a practice setting.
Read a selection of your colleagues’ responses.
By Day 7, respond to two of your colleagues in one or more of the following ways:
Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Click on the Reply button below to post your response.
NURS 8300 Week 2: Quality Indicators Discussion SAMPLE
Analyze Two Nurse Sensitive Indicators of Quality Using Early Quality Improvement Theories and Philosophies
The American Nurses Association (ANA) defined nurse-sensitive indicators of that quality measures that are “most affected by nursing care” (ANA, 1996). As a Registered Nurse I can certainly appreciate the link between nursing care and patient outcomes. Interestingly, a concept analysis to understand nurse sensitive indicators concluded that while nurse-sensitive indicators focus on nursing performance, the lack of “conceptual foundation and theoretical structures” may hinder the application of the context in the clinical setting (Heslop & Lu, 2014). Therefore, I reviewed a pioneer in the field of quality Avedis Donabedian (1980) to analyze his influence early improvement theories in healthcare.
Donabedian’s Model evaluates the quality of care in one of three relational measures: structure, process and outcomes (Donabedian, 1980). Donabedian’s Model to improve falls I would suggest that, factors to influence structure include items such as organizational culture, staff training and adequacy of staffing levels and equipment. Factors that influence process include fall risk assessment, medication administrations, staff/patient communication and teamwork through hourly rounding. Outcomes measure whether the goal was achieved, including patient satisfaction.
Donabedian’s Model to improve pressure ulcers falls I would suggest that, factors to influence structure include items such as organizational culture, staff training and adequacy of staffing levels and equipment. Factors that influence process include pressure ulcer risk assessment, nutritional status , staff/patient communication and teamwork through hourly rounding. Outcomes measure whether the goal was achieved, including patient satisfaction.
Based on the evaluation of falls and pressure ulcer nurse-sensitive indicators, using the Donabedian Model, it is doubtful that the outcomes will be constant. Joshi (2014) identified that simply using an outcome measurement as an indicator of quality care, is not always reliable, as good outcomes can result even when the care is deficient and bad outcomes can result even when the care is excellent.
How Nursing Research Influence a Practice Setting in Patient Falls and Pressure Ulcers..
Quality Indicators Discussion
NURS 8300 Assignment: Major Assessment 6
This Assignment requires completion of 13 IHI Open School modules and the completion of the Certificate of Completion Basic level. There are 13 modules which you must complete over the course of these 11 weeks. While they are learner paced, it is to your advantage to complete the modules in the week assigned as the content of the course is related to the modules.
To earn the 30 points associated with this application, you must complete all 13 modules and earn the certificate of completion. Partial credit is not permitted.
IHI Open School Modules
Week 2: QI 102: How to Improve with the Model for Improvement
Week 2: QI 103: Testing and Measuring Changes with PDSA Cycles
There is nothing to submit this week.
Please save the certificate you receive upon completion. You will be required to upload this to gradebook in evidence of your completion.
NURS 8300 Week 2: Definitions of Quality
How will you know where you are going if you do not know where you have been? This common cliché is reflective of the influence that early theorists of quality improvement have on health care practices today. Building on theories and philosophies of quality from the field of management, successful health care organizations recognize that quality assessment and improvement are central to clinical service delivery. These organizations integrate this perspective into their day-to-day operations. Leaders in health care and nursing practice benefit from implementing those practices that have been developed by prominent theorists within the management field.
This week, you examine the influence of early theories of quality improvement. You also identify and evaluate health care quality and nurse-sensitive indicators.
Learning Objectives
By the end of this week, you will be able to:
Analyze the historical development of the theories and philosophies of clinical quality and safety in health care
Evaluate the influence of nurse-sensitive indicators of quality
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Quality Indicators Discussion Required Readings
Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Adminisration Press.
Chapter 3: “Variation in Medical Practice and Implications for Quality”
Chapter 4: “QI Foundation, Processes, Tools and Knowledge Transfer Techniques”
Chaboyer, W., Johnson, J., Hardy, L., Gehrke, T., & Panuwatwanich, K. (2010). Transforming care strategies and nursing-sensitive patient outcomes. Journal of Advanced Nursing, 66(5), 1111–1119. doi: 10.1111/j.1365-2648.2010.05272.x
Note: You will access this article from the Walden Library databases.
The authors of this article attempt to reduce medication errors, patient falls, and ulcers by using Transforming Care at the Bedside, which is a framework that values safety and reliability, creates a good work environment, is centered on the patient, and increases value. They conclude that these principles are able to positively affect their patients, but some aspects of the study may be inconclusive.
Gerritsen, D.L., & van Beek, A. P. A. (2010). The relationship between organizational culture of nursing staff and quality of care for residents with dementia: Questionnaire surveys and systematic observations in nursing homes. International Journal of Nursing Studies, 47(10), 1272–1282.
Note: You will access this article from the Walden Library databases.
After briefly discussing the background of organizational culture, the study in this article focuses on how organizational culture affects quality of care in long-term care. It uses two independent measurements and determines that different styles of organizational culture affect the quality of care.
The American Nurses Association, Inc. (2011). Nursing-sensitive indicators. Retrieved from http://web.archive.org/web/20120921021800/http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/PatientSafetyQuality/Research-Measurement/The-National-Database/Nursing-Sensitive-Indicators_1.aspx
From the American Nurses Association, this article discusses nursing-sensitive indicators. It provides a definition of the term and then describes the development process and indicator list.
American Nurses Association. (2011). National Database of Nursing Quality Indicators. Retrieved from http://www.nursingworld.org/
This website acts as a database for unit-specific nurse-sensitive information that comes from multiple health care organizations.
Agency for Healthcare Research and Quality. (n.d.) Retrieved from http://www.ahrq.gov/
The provided link takes you to the homepage of the Agency for Healthcare Research and Quality (AHRQ), where you can find information about improving safety and quality in the health care industry.
National Quality Forum. (2011). Retrieved from http://www.qualityforum.org/Home.aspx
Various members of the health care community can become members of the National Quality Forum (NQF) through this site. The nonprofit organization NQF aims to increase quality improvement for its members.
Quality Indicators Discussion Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Name: NURS_8300_ Week2_Discussion_Rubric
Grid View
List View
Excellent
Good
Fair
Poor
RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements:
*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.
8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.
7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.
6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.
0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE
8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.
7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.
6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course
0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION
8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.
7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature
6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.
0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING
6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
5 (16.67%) – 5 (16.67%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.
4 (13.33%) – 4 (13.33%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.
0 (0%) – 3 (10%)
Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Total Points: 30
Name: NURS_8300_ Week2_Discussion_Rubric
