NUR 630 Overview of Quality in Health Care
Overview of Quality in Health Care
Healthcare providers should consistently offer services that address patient needs comprehensively. Patient outcomes should be high, which indicates effective and successful interventions and services (Bhati et al., 2023). To ensure effective interventions, nursing professionals and leaders must understand quality and patient safety concerns, risk factors, and potential solutions. Evidence-based interventions are the most recommended in nursing since they are associated with positive outcomes for patients, care providers, and organizations. The purpose of this paper is to describe a patient safety concern and explore how evidence-based practice (EBP), research, and performance improvement (PI) can be used to address it to improve patient outcomes.
Description of Issue and Challenges
Patient falls remain a prevalent problem in healthcare settings despite increased attention and multimodal solutions implemented to prevent them. Like other safety concerns, patient falls rates vary across settings, and approximately 25% of the incidences result in injuries and fractures (Heng et al., 2020). Patient- and system-based factors increase the risk of falls among older adults. Patient factors include risky behaviors, like not pressing the call bell when visiting the toilet and unsupervised walking, cognitive impairment, and failing to seek help from health professionals (Heng et al., 2020). System-level factors include overcrowding, inadequate fall risk assessment, and a lack of assistive devices.
The far-reaching effects of patient falls indicate a significant challenge for patients, nurses, and leaders. Among patients, falls hamper the quality of life, cause painful injuries and fractures, and result in trauma due to fear of falling (Heng et al., 2020; Stathopoulos et al., 2021). Fear of falling reduces the patient’s mobility, implying reduced participation in activities of daily living. Besides these adverse outcomes, patient falls increase hospitalization, hence more workload for nurses and consumption of health resources (Dabkowski et al., 2022). These challenges underscore a severe problem that obliges nurses to engage in fall prevention programs and support patients in abiding by the recommended safety measures in the clinical environment.
Utilizing EBP, Research, and PI
EBP can be used to address patient falls by guiding nurses in implementing best practices supported by evidence. Grys (2022) described EBP initiatives as translating existing evidence on patient care to address systemic questions or improve safety and quality outcomes. Applying EBP implies exploring scientific evidence on the most effective solutions for patient falls in healthcare facilities. After analyzing and appraising the results, nurses implement an evidence-based project to reduce the risk of patient falls in their respective settings. They also evaluate outcomes to determine the feasibility of the EBP initiative and identify areas of improvement.
Nurses need new knowledge on issues hampering patient safety and care quality to improve decision-making. In nursing and the wider healthcare field, research is an inquiry process for generating new evidence using a scientific method (Grys, 2022). Commonly, researchers test a hypothesis, collect data, analyze results, and use the findings as a knowledge base applicable to the healthcare facility and related settings. Research can be used to explore the causes of patient falls and the suitability of the present methods in a setting. It can also be used to examine patients’ and nurses’ perceptions of the current fall prevention methods to establish gaps between the achieved and desired outcomes.
Performance improvement is instrumental in making positive changes in the value of care. Bertke and Nufer (2021) described performance enhancement as enhancing medical core processes along the patient journey. Healthcare professionals engaging in performance enhancement first examine the core processes and implement the necessary improvements through innovation. Focus change areas include the status quo, quality, and daily practices. Regarding quality, improvement projects fix persistent problems or build new processes specific to the local practice (Crystal, 2022). Nurses are informed by local data or evidence from the scientific literature to determine where changes are needed and how to make the desired improvements.
PI and QI Process
Nursing professionals can use various performance or quality improvement processes to reduce the risk of patient falls in healthcare settings. Patient education would effectively achieve this goal to ensure safe environments, high patient satisfaction, and patient trust in the care process. Heng et al. (2020) recommended patient education initiatives to increase patients’ awareness of fall risk and guide them in adopting measures to mitigate falls while hospitalized. Patient education methods include handouts, face-to-face discussions about risk prevention, and posters. For better outcomes, patient education should be informed by leading educational theories and seek to influence behavior change.
The main reason for choosing patient education is its evidence-based nature. Studies such as Heng et al. (2020) and Heng et al. (2021) link patient education with improved outcomes regarding patient falls through increased awareness of risks and safety strategies. Patient education is also easy to implement since nurses can make handouts and posters and share them with patients without experiencing significant challenges. The other reason is the outcome-oriented nature of the process. Whether as part of a multifactorial initiative or as a single program, patient education can effectively reduce fall-related outcomes.
Data Sources
Data is crucial for informing nursing professionals about the effectiveness of performance or quality improvement initiatives. Among many methods, clinical records are a reliable outcome data source since the incidences of patient falls are accurately documented therein. Departmental leaders can provide such data for the project leader to make a comparative analysis of outcomes. Process data can be obtained via surveys. In nursing, surveys help researchers and care providers gather primary data from a target population to address gaps in a particular area (O’Connor, 2022). Such surveys can also be used to evaluate risk factors for patient falls and perceptions of patient education among nurses and patients.
Capturing and Disseminating Data
Data will be captured both quantitatively and qualitatively using appropriate tools. The quantitative data is primarily on the rates of patient falls in the organization before, during, and after the patient education initiative. This data can be captured electronically. Questionnaires are a reliable survey method for asking relevant questions regarding patient education and its effectiveness as a risk reduction program for patient falls. Data on experiences will be captured qualitatively. Findings in each area will be summarized in a comprehensive report that can be shared with nursing professionals and organizational leaders. Dissemination is crucial in research and healthcare processes to share information and materials with other users within the health practice area (Barría, 2022). The nature of performance improvement initiatives like patient education necessitates internal dissemination. Effective internal dissemination strategies include an organization-wide presentation of findings to stakeholders, distributing educational materials like brochures and pamphlets, and sharing a toolkit of fall prevention strategies.
Organizational Culture Considerations
Organizational culture is a critical determinant of a quality improvement project’s success. Palumbo and Douglas (2024) underscored the importance of organizational culture in quality management since it shapes individual behaviors, attitudes, and commitment to new ideas. Leadership is a cultural element that affects organizational change and quality improvement outcomes. In an organization with a strong culture of quality, leaders are committed to initiating and leading transformational change processes (NACCHO, 2020). As primary stakeholders, leaders directly support quality improvement and ensure those responsible are held accountable. The other success determinant is shared values, particularly collaboration and shared responsibility. Team members who value collaborative practices support each other in achieving a common goal like reducing patient falls in the organization. The third important factor is quality improvement infrastructure. Irrespective of the size and leadership approach, organizations should have strong systems and infrastructure that support performance improvement to achieve the desired success.
Conclusion
Nurses should ensure patients receive care in safe clinical settings and that their needs are addressed comprehensively. Addressing patient safety issues like patient falls underlines nurses’ commitment to optimizing patient outcomes and reducing costs. Among other methods, a patient education program is a feasible initiative for reducing the risk of falls in healthcare facilities. It is an evidence-based strategy that increases fall risk awareness and guides patients in adopting appropriate measures to avoid falls. Nurses should collect data and share findings with stakeholders when implementing such an initiative. The dissemination helps other clinicians understand the value of a project and implement it to achieve similar results.
References
Barría, P R. M. (2022). Nursing research, dissemination of knowledge and its potential contribution to the practice. Investigacion Y Educacion En Enfermeria, 40(3), e01. https://doi.org/10.17533/udea.iee.v40n3e01
Bertke, P., & Nufer, M. (2021). The impact of performance enhancement on value of care in hospitals. Frontiers in Public Health, 9, 740257. https://doi.org/10.3389/fpubh.2021.740257
Bhati, D., Deogade, M. S., & Kanyal, D. (2023). Improving patient outcomes through effective hospital administration: a comprehensive review. Cureus, 15(10), e47731. https://doi.org/10.7759/cureus.47731
Dabkowski, E., Cooper, S. J., Duncan, J. R., & Missen, K. (2022). Exploring hospital inpatients’ awareness of their falls risk: a qualitative exploratory study. International Journal of Environmental Research and Public Health, 20(1), 454. https://doi.org/10.3390/ijerph20010454
Grys, C. A. (2022). Evidence-based practice, quality improvement, and research: a visual model. Nursing2023, 52(11), 47-49. DOI: 10.1097/01.NURSE.0000889812.89287.45
Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital falls prevention with patient education: a scoping review. BMC Geriatrics, 20, 1-12. https://doi.org/10.1186/s12877-020-01515-w
Heng, H., Slade, S. C., Jazayeri, D., Jones, C., Hill, A. M., Kiegaldie, D., … & Morris, M. E. (2021). Patient perspectives on hospital falls prevention education. Frontiers in Public Health, 9, 592440. https://doi.org/10.3389/fpubh.2021.592440
NACCHO. (2024). Foundational elements of a QI culture. https://virtualcommunities.naccho.org/qi-roadmap/elements#:~:text=To%20achieve%20a%20culture%20of,to%20organizational%20and%20individual%20performance.
O’Connor, S. (2022). Designing and using surveys in nursing research: a contemporary discussion. Clinical Nursing Research, 31(4), 567–570. https://doi.org/10.1177/10547738211064739
Palumbo, R., & Douglas, A. (2024). The secret ingredient? Uncovering the effect of organizational culture on quality management: a literature review. International Journal of Quality & Reliability Management, 41(1), 195-268. https://doi.org/10.1108/IJQRM-03-2023-0077
Stathopoulos, D., Ekvall Hansson, E., & Stigmar, K. (2021). Exploring the environment behind in-patient falls and their relation to hospital overcrowdedness-a register-based observational study. International Journal of Environmental Research and Public Health, 18(20), 10742. https://doi.org/10.3390/ijerph182010742
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Assessment Traits
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Assessment Description
The purpose of this assignment is to apply the concepts you have learned in this course to a situation you have encountered. Choose one quality or patient safety concern with which you are familiar and that you have not yet discussed in this course. In a 1,250-1,500-word essay, reflect on what you have learned in this course by applying the concepts to the quality or patient safety concern you have selected. Include the following in your essay:
- Briefly describe the issue and associated challenges.
- Explain how EBP, research, and PI would be utilized to address the issue.
- Explain the PI or QI process you would apply and discuss why you chose it.
- Describe your data sources, including outcome and process data.
- Explain how the data will be captured and disseminated.
- Discuss which organizational culture considerations will be essential to the success of your work. This assignment uses a rubric.
Use a minimum of four peer-reviewed, scholarly sources as evidence.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.