NUR 630 Week 8: Overview of Quality in Health Care

NUR 630 Week 8: Overview of Quality in Health Care

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:

1. Briefly describe the issue and associated challenges.
2. Explain how EBP, research, and PI would be utilized to address the issue.
3. Explain the PI or QI process you would apply and discuss why you chose it.
4. Describe your data sources, including outcome and process data.
5. Explain how the data will be captured and disseminated.
6. Discuss which organizational culture considerations will be essential to the success of your work.

Use a minimum of six peer-reviewed, scholarly sources as evidence.

 

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Sample Research Paper : Overview of Quality in Health Care

Care quality is a priority for patients and health care professionals. As a result, nurses should do everything possible to ensure that patients receive quality care. Although nurses engage in many activities to optimize care quality, multiple quality concerns are experienced in different settings. Their magnitude varies depending on their cause, people affected, and solutions required. To solve the known and emerging problems, nurses should be adequately conversant with evidence-based practice (EBP), research, and performance improvement (PI). The purpose of this paper is to describe a familiar quality concern and how EBP, research, and PI would be utilized to address the issue.

Issue Description and Associated Challenges

In nursing practice, quality of care is directly proportional to nurses’ health and well-being. Consequently, all events and workplace issues that hamper nurses’ health adversely affect care quality. Among many issues, the upsurge of COVID-19 patients and the intensity of care required in the emergency department have been severe issues among nurses in the emergency department. According to Bartzik et al. (2021), the COVID-19 pandemic is a significant health challenge since it drains nurses’ emotional and mental health and well-being. ED nurses find it hard to cope with the pandemic and the intensity required due to anxiety, increased workload, and many changes in their work routine. Fauteux (2021) observed that approximately 40% of nurses in acute care settings have become demotivated and find the nursing career no longer satisfying. The drop in career satisfaction, burnout, and other adverse outcomes are detrimental to care quality and patient safety.

COVID-19 management has many challenges. It has brought a new dimension to illness management since nurses must protect themselves, colleagues, and their families while taking care of patients. The other challenge is the inevitable decline in care quality due to loss of motivation and increased workload since nurses cannot diagnose and treat patients accurately and holistically. Kichloo et al. (2020) asserted that nurse-patient interaction has also reduced since many facilities opt for telemedicine for remote care to minimize physical contact. Overall, the impacts are many and sweeping. Patients are no longer guaranteed maximum time, and nurses’ health and well-being are also at risk of progressive decline.

Utilizing EBP, Research, and PI

As aforementioned, nurses’ health and well-being affect care quality significantly. Nurses should always function optimally to take care of patients as professionally and ethically expected. EBP recommends utilizing scientific evidence, clinical expertise, and patient preferences to improve the quality of care (Chien, 2019). As a core component of EBP, scientific evidence can help improve care quality in the ED by addressing the challenges of COVID-19 management. Through EBP, nurses and nurse leaders can search for scientifically recommended practices for enhancing nurses’ psychological well-being in the ED. Such evidence includes systematic reviews, randomized controlled trials, and observational studies. For instance, a narrative literature review on coping strategies found faith-based practices, social support, and psychological support effective in empowering nurses to cope with COVID-19 pandemic challenges (Sehularo et al., 2021). Using such evidence for practice change signifies EBP utilization.

Research can also be utilized to address the challenges of nurses’ mental and emotional exhaustion to enable them to deal with the COVID-19 pandemic effectively. Chien (2019) described nursing research as developing new knowledge using a methodology (quantitative or qualitative). The knowledge developed is used to guide EBP interventions. Suitable research on COVID-19 management is a qualitative study of nurses’ emotional and mental challenges to help develop appropriate interventions. Another appropriate research is grouping nurses in experimental and control groups to study the effectiveness of psychiatry help or support groups on psychological well-being. If effective, the interventions would be replicated in other nurses to enable them to cope with the challenges of COVID-19 management effectively.

PI involves the continuous study and adaptation of processes designed to achieve the desired outcomes. Its primary objective in health care delivery is ensuring that health care professionals can address patient needs better and more readily (Batalden, 2018). PI addresses performance gaps between the current and desired results. Utilizing PI to address COVID-19 management challenges would prompt leaders and staff to adopt research or EBP to enable nurses to perform better and effectively cope with the increasing workload and mental and emotional challenges. Expected outcomes of PI include increased motivation, high resilience, healthy workplace relationships, and better patient-provider relationships.

Relevant PI or QI Process

Psychological support is among the widely studied themes in nursing literature exploring support to nurses experiencing emotional and mental challenges due to the COVID-19 pandemic. It would be an effective QI initiative since it enables nurses to cope with emotional suffering and mental stress stemming from the COVID-19 pandemic (Sehularo et al., 2021). Psychological support is necessary since nurses in the ED encounter traumatic events while providing care to patients in distress. Practical measures for psychological support include guided meditation, mindfulness techniques, spirituality, and resilience strategies. Interventions to improve nurses’ motivation can also help them cope with the situation better.

The main reason for selecting psychological support is its problem-centeredness and helping to prevent nurse turnover. It is problem-centered since most problems nurses experience during COVID-19 management are psychological. The pandemic also exposes them more to depression (Motahedi et al., 2021). Preventing such outcomes would enable nurses to provide timely and effective care hence optimizing care quality. Nurse turnover is also low among motivated and resilient nurses. Preventing turnover ensures care continuity and care coordination, which are integral in enhancing care quality.

Data Sources, Including Outcome and Process Data

Data can be used to illustrate and evaluate various elements of the proposed QI process (psychological support). Outcome data can be sourced from clinical records on nurses’ changes in health and well-being after guided meditation, mindfulness, motivation, and other interventions. The other potential source of outcome data is a factsheet of the turnover rates before and after psychological support interventions. Process data can be collected from patients and nurses describing their experiences with care and psychological support effectively. Patients can describe how nurses treat them (professional support and patient-provider relationship), while nurses can provide narrative reviews about their experience with the support and targeted outcomes.

Data Capturing and Dissemination

Data will be captured both quantitatively and qualitatively. Mixed methods enrich the concept being explored and ensure that it is better understood from multiple dimensions (Regnault et al., 2018). Quantitative data will be captured via questionnaires, clinical records, and factsheets. Qualitative data will be captured through interviews and recorded in summary documents and reports. Dissemination involves sharing evidence internally and with the wider nursing practice. Internally, an organization-wide presentation, handouts, and brochures can effectively disseminate the findings. A summary of the effectiveness of psychological support and strategies that nurses can use for self-care will be published on the facility’s education page. External dissemination strategies include presenting to nursing associations and publishing in professional journals, albeit not a current priority.

Organizational Culture Considerations

The organizational culture affects the outcomes of quality improvement projects significantly. A key consideration essential to the success of the QI proposal is readiness for change. Dearing (2018) described readiness for change as the motivation and capacity to support interventions to improve health outcomes. Defining elements include the organization’s resources to offer psychological support and leadership support. Other factors include understanding and perception of EBP and research. These considerations imply that barriers to quality improvement should be minimal. The other important cultural consideration is the shared values and beliefs. The leaders and staff should collaborate to identify and address problems hampering care quality in their organizations. Leaders should be transformative to inspire the staff in the desired direction. The last and most important factor is stakeholder support. Internal and external stakeholders should readily support the organization when engaging in quality improvement initiatives.

Conclusion

Care quality should be a priority in health care organizations. As a result, leaders and staff should be actively involved in identifying problems hampering care quality and addressing them effectively. As discussed in this paper, EBP, research, and PI can be utilized to address nurses’ mental health and well-being problems stemming from COVID-19 pandemic management. The problems have intensified due to increased workload, anxiety, and encountering many traumatic experiences. Psychological support would be an effective QI process since it would enable nurses to cope with stressful situations and prevent nurse turnover. Preventing these problems would guarantee patients continued support, timely care, and adequate attention before, during, and after a hospital visit.

 

 

References

Bartzik, M., Aust, F., & Peifer, C. (2021). Negative effects of the COVID-19 pandemic on nurses can be buffered by a sense of humor and appreciation. BMC Nursing, 20(1), 1-12. https://doi.org/10.1186/s12912-021-00770-5

Batalden, P. (2018). Getting more health from healthcare: Quality improvement must acknowledge patient coproduction—an essay by Paul Batalden. The BMJ, 362, k3617. https://doi.org/10.1136/bmj.k3617

Chien, L. Y. (2019). Evidence-Based Practice and Nursing Research. The Journal of Nursing Research : JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346

Dearing, J. W. (2018). Organizational readiness tools for global health intervention: A review. Frontiers in Public Health, 6, 56. https://doi.org/10.3389/fpubh.2018.00056

Fauteux, N. (2021). COVID-19: impact on nurses and nursing. AJN The American Journal of Nursing, 121(5), 19-21. doi: 10.1097/01.NAJ.0000751076.87046.19

Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., … & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: A narrative review and perspectives moving forward in the USA. Family Medicine and Community Health, 8(3): e000530 https://doi.org/10.1136%2Ffmch-2020-000530

Motahedi, S., Aghdam, N. F., Khajeh, M., Baha, R., Aliyari, R., & Bagheri, H. (2021). Anxiety and depression among healthcare workers during COVID-19 pandemic: A cross-sectional study. Heliyon, 7(12), e08570. https://doi.org/10.1016/j.heliyon.2021.e08570

Regnault, A., Willgoss, T., & Barbic, S. (2018). Towards the use of mixed methods inquiry as best practice in health outcomes research. Journal of Patient-Reported Outcomes, 2(1), 1-4. https://doi.org/10.1186/s41687-018-0043-8

Sehularo, L. A., Molato, B. J., Mokgaola, I. O., & Gause, G. (2021). Coping strategies used by nurses during the COVID-19 pandemic: A narrative literature review. Health SA = SA Gesondheid, 26, 1652. https://doi.org/10.4102/hsag.v26i0.1652