NURS 8302 Week 2: QUALITY INDICATORS

Walden University NURS 8302 Week 2: QUALITY INDICATORS– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8302 Week 2: 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 Week 2: QUALITY INDICATORS

Whether one passes or fails an academic assignment such as the Walden University NURS 8302 Week 2: 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 Week 2: QUALITY INDICATORS

The introduction for the Walden University NURS 8302 Week 2: 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 Week 2: QUALITY INDICATORS

After the introduction, move into the main part of the NURS 8302 Week 2: 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 Week 2: 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 Week 2: 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 Week 2: QUALITY INDICATORS

Quality Indicator 1 – Pressure Ulcer Prevalence and Incidence

Nurses pay attention to pressure ulcers or bedsores. A pressure ulcer is a tiny skin and/or tissue damage caused by pressure, shear, or both. Pressure ulcer incidence and prevalence are essential for assessing prevention strategies and nursing treatment. Pressure ulcer indicators were influenced by the Donabedian model and other early quality improvement theories that evaluated healthcare structure, method, and outcomes (Chen, Liao, & Zhou, 2023). This pressure ulcer prevention paradigm prioritizes outcomes, which patients need.

Influence of Early Quality Improvement Theories:

Pressure ulcer indicators are shaped by the Donabedian approach, which emphasizes comprehensive quality evaluation. Structures (such as resources and staff), processes (such as preventative measures), and results (such as pressure ulcer prevalence and incidence) are examined. As part of a complete pressure ulcer prevention strategy, the model emphasizes how these factors interact and affect patient outcomes.

Nursing Research Article:

Taylor, Mulligan, and McGraw’s article “Barriers and enablers to the implementation of Evidence-based Practice in pressure ulcer prevention and management in an integrated community care setting” (2021) explores factors affecting the adoption of evidence-based practices in pressure ulcer prevention. This research is relevant to my profession since it sheds light on pressure ulcer prevention challenges and opportunities. The study’s findings could help my company enhance quality by revealing issues like finances and personnel education.

Quality Indicator 2 – Patient Falls

Nurses also include patient falls when assessing nursing care quality and safety. Falls can cause injuries and impact patient outcomes. Fall indicators are influenced by Deming’s PDSA cycle, which emphasizes repeating cycles of planning, doing, studying, and acting to enhance quality (Brandrud, 2019).

Influence of Early Quality Improvement Theories:

The PDSA cycle has advanced fall indicators by promoting a deliberate and iterative quality improvement technique. Continuous outcome evaluation allows nursing interventions to be implemented, evaluated, and adjusted to avoid falls. Constant improvement and adaptability increase nursing care and patient safety.

Nursing Research Article:

The study “Quality Indicators for the care and Outcomes of adults with atrial fibrillation” by Arbelo et al. (2021) highlights quality indicators in patient care, but not specifically in falls. It shows how quality indicators are used in healthcare. This and similar studies can inspire interdisciplinary teams to establish comprehensive quality improvement initiatives to prevent patient falls in my practice using proven strategies from other areas.

To summarize, the creation of nurse-sensitive indicators necessitates comprehension and use of early quality improvement ideas. The selected papers provide valuable insights into the challenges and opportunities for improving patient care and preventing pressure ulcers. These criteria are essential for guiding quality improvement programs to ensure that patients receive high-quality nursing care.

Reference:

Arbelo, E., (Chair), Aktaa, S., Bollmann, A., D’Avila, A., Drossart, I., … & Martins Oliveira, M. (2021). Quality indicators for the care and outcomes of adults with atrial fibrillation: task force for the development of quality indicators in atrial fibrillation of the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC): developed in collaboration with the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS). EP Europace, 23(4), 494-495.

Brandrud, A. S. (2019). Learning about the conditions for improvement and excellent care from high performing clinical networks.

Chen, X., Liao, P., & Zhou, Y. (2023). Construction of nursing-sensitive quality indicators for the care of patients with prone position ventilation using the Delphi method. BMC nursing, 22(1), 336.

Evangelou, E., Middleton, N., Kyprianou, T., Kouta, C., Merkouris, A., Raftopoulos, V., … & Lambrinou, E. (2021). Nursing quality indicators for adult intensive care: a consensus study. Nursing in Critical Care, 26(4), 234-243.

Taylor, C., Mulligan, K., & McGraw, C. (2021). Barriers and enablers to the implementation of evidence‐based practice in pressure ulcer prevention and management in an integrated community care setting: A qualitative study informed by the theoretical domains framework. Health & Social Care in the Community, 29(3), 766-779.

Sample Answer 2 for NURS 8302 Week 2: QUALITY INDICATORS

Sensitive Quality Indicators

The field of nursing focuses on quality and this constitutes what can be done for the improvement of standards across the healthcare system. The consideration for quality in mental health nursing goes back to Florence Nightingale’s introduction of research to nursing and specifically her reliance on statistical methods to connect care outcomes with environmental concerns. Nurse-sensitive indicators provide a conceptual foundation and theoretical structure to guide nursing performance. In this case, some of the nursing-sensitive indicators that mental health nurses rely on for the provision of the best care are regarding psychiatric physical/sexual abuse rate and restraint prevalence. Early quality improvement theories and philosophies served to not only increase consideration for these indicators but also improve their outcomes in nursing practice. The theories ensured that the indicators were evidence-based by reviewing scientific research for evidence that the specific aspect of nursing impacts nursing outcomes, the specific meanings of the indicators, and evidence for the valid and reliable measuring of the indicators (Montalvo, 2007). The early theories and philosophies for improvement of the indicators resulted in the revision of the definitions and guidelines for the indicators.

The theories and philosophies also allow for input from experts. For instance, theories in mental health regarding psychiatric physical/sexual abuse rate and restraint prevalence in the field. When it comes to restraint prevalence as a nursing-sensitive quality indicator, Ngune et al. (2023) found that decreased restraint was associated with increased nursing staffing and a higher nurse-patient ratio. While other researchers found no link between years of experience as a nurse and restraint use, others found that nurses were more likely to use restraints if they had more experience as RNs or more years of experience as psychiatric nurses. Ngune et al. (2023) found a relationship between restraint and gender, with male nurses using physical restraint more often. In terms of regarding psychiatric physical/sexual abuse rate, some of the research relates to the prevalence and severity of physical, verbal, and sexual violence against nurses in psychiatric hospitals. According to Schlup, Gehri, and Simon (2021), strategies like aggression management courses or the use of alarms are not fully effective in limiting patient violence against care providers in psychiatry. Instead, there is a need for proactive strategies in safety and violence prevention since patient violence against nurses is a serious and recurrent issue in mental health care settings.

 Schlup, Gehri, and Simon (2021) indicate that other than physical injuries, nurses in such settings are exposed to psychological consequences that include stress and feelings of anger or fear. Psychiatric physical/sexual abuse rate and restraint prevalence as indicators can influence my practice setting by allowing me and my colleagues to measure the impact of our work on mental care provision. For instance, if the aggression levels among patients in the setting reduce, this will be defined as an outcome element in the form of a change in health status in the positive direction. In this case, changes in aggression levels will result in limited use of restraint on the patient and reduced physical attacks on the staff. Psychiatric physical/sexual abuse rate and restraint prevalence are useful indicators for my mental health setting as they increase the confidence in myself and my colleagues when providing mental healthcare by making us know that we have the tools, knowledge, and assistance to bring about positive change to the setting and the field.

References

Montalvo, I. (2007). The national database of nursing quality indicators (NDNQI). Online Journal of Issues in Nursing, 12(3).

Ngune, I., Myers, H., Cole, A., Palamara, P., Redknap, R., Roche, M., & Twigg, D. (2023). Developing nurse‐sensitive outcomes in acute inpatient mental health settings—A systematic review. Journal of Clinical Nursing.

Schlup, N., Gehri, B., & Simon, M. (2021). Prevalence and severity of verbal, physical, and sexual inpatient violence against nurses in Swiss psychiatric hospitals and associated nurse‐related characteristics: Cross‐sectional multicentre study. International journal of mental health nursing, 30(6), 1550-1563.

Sample Answer 3 for NURS 8302 Week 2: 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 Week 2: 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.