Introduction
Today, much attention is paid to the development and improvement of nursing science due to its initial goal of promoting high-level patient-centered care. Nurses have to demonstrate their knowledge and make sure to apply different theories and frameworks in practice. Nursing theory is based on a group of interrelated concepts that are used to describe and explain how to analyze patient data (Matney, Avant, & Staggers, 2015). However, the application of theory may not be sufficient, because it is expected to contribute to the development of a safe healthcare environment where quality and outcomes are measured. According to Sherwood (2017), quality and safety are deeply intertwined, and an incomplete understanding of them may result in increased risks and harm to patients, which is not acceptable. Quality and safety measures play a crucial role in nursing science today, and the goal of this paper is to describe the relationships between these concepts in the field of nursing, as well as to identify their metrics and components for healthcare program evaluation.
Understanding of Quality and Safety Measures in Nursing Science
Nursing science is a field where several medical and healthcare services are offered to patients and their families. The sustainability of nursing depends on how well nurses can understand their responsibilities and apply quality and safety measures in practice. Barrett is a researcher who has spent many years proving the worth of nursing science. One of the most recent definitions of nursing science is “the substantive discipline-specific knowledge that focuses on the human-universe-health process articulated in the nursing frameworks and theories” (Barrett, 2017, p. 130). Nurses serve the public good by obtaining knowledge and certifications, and people expect to receive safe care of high quality (Jones, 2016). As a result, the interaction of these two factors determines the relationship between quality and safety for nursing science.
Quality and Safety Essence
Even though nurses usually apply quality and safety measures simultaneously due to their close interrelation, it is necessary to understand that these are two different concepts. Quality improvement aims at monitoring data and cares outcomes to promote positive changes in care, identify new caring methods and approaches, and enhance health care delivery (Johnson, 2017). Safety measurement focuses on organizational frameworks where risks to patients’ health are minimized, nurse performance is analyzed, and human errors are predicted (Barnsteiner, 2017). In other words, safety ensures that the quality of care is high because of the absence of all kinds of risks and threats.
Relationship to Nursing Science
The relationship between quality and safety in nursing science is rooted in understanding nurses’ duties and responsibilities. Many studies explain how crucial the role of nurses in primary patient contact can be as it ensures further success and quality of care (Salmond & Echevarria, 2017; Swart, Pretorius, & Klopper, 2015). In addition, Brennan and Bakken (2015) explain nursing science as a multifaceted field where big data is available from various sources to illuminate nursing concepts and expectations. Treatment goals may vary in patients, but such characteristics as healing, patients’ safety, the security of personal information, and cooperation with families measure the quality of care and create a strong working environment.
Role and Outcomes of Quality/Safety Measures
When the role of nursing science, as well as safety and quality measures, has been demonstrated, the time has then come to think about types of measures and potential outcomes of their implementation in nursing practice. Quality measures are tools with whose aid various nursing processes and outcomes and patient attitudes can be identified and quantified from both the nurse and patient perspectives (Glarcher, Schumacher, & Fritz, 2015). The role of these measures is not only to identify errors and comprehend what people think about the services offered, but also to obtain a fuller picture of public health and understand if care is effective, safe, patient-centered, and timely (Flynn, Scott, Rotter, & Hartfield, 2016). The outcomes of implementing such measures range from identifying a need to clarify patient needs and expectations, to requiring new leadership and a re-evaluation of human resources.
Example of Quality and Safety Application in Nursing Science
In modern healthcare and nursing, there are many examples of effectively applying quality and safety measures. Various organizations make regular contributions to the improvement of quality and safety in patient care, including the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), and the American Academy of Pediatrics (AAP). According to Adirim, Meade, and Mistry (2016), quality measures promote improvements in clinical care, the establishment of regulations, accreditation, monitoring, and program development. These measures are categorized into three major types – structural, process, and outcome. Structural measures reveal how effectively a system works in nursing science. Process measures indicate what steps should be taken to improve health, avoid problems, and deal with diagnoses. Finally, outcome measures aim at reflecting the impact of services or different programs on patient health. For nurses, outcome quality measures have several benefits due to the possibility of improving their performance and providing information about the results achieved. Nurses learn how to take action to influence outcomes and provide patients with effective care, for example, mortality rate control.
Among the current range of measurement tools, mortality rates are frequently used to evaluate patient outcomes and the quality of care offered by nurses. In her study, Ball (2017) explained hospital mortality rates as a way to measure the number of deaths related to patients’ conditions and nursing care. Griffiths et al. (2018) also connected the quality of nursing care with the number of deaths in hospitals. Reports from the CDC, AAP, and AHRQ demonstrate the recent progress in care quality and show if nursing care is safe enough to predict patients’ deaths. These outcome measures are applied by nursing science as a chance to identify the reasons for patient mortality and help nurses in their intentions to support patients. Such diseases as heart attack, cancer, diabetes, and Alzheimer’s are at the top of the list of leading causes of death (Centers for Diseases Control and Prevention, 2018). Nurses have to pay special attention to patients with these diseases, support their families, and provide education to reduce the risks of death or developing new health problems.
Quality Components to Analyze Program Outcomes
Program evaluation is based on gathering information about a program, including its goals, main characteristics, activities promoted and outcomes achieved. Evaluation is not only about making judgments and identifying programs’ strong and weak aspects, but also about the necessity of understanding what can be done to improve their effectiveness and reach the necessary results. Program evaluation may be of two types: process (where formative information is gathered to understand how everything is done) and outcome (where summative information is presented to explain what should be done).
Each evaluator is free to choose quality components to analyze a program and explain how nursing science is applied within a given context. In nursing care, many factors determine a program’s quality and outcomes, and the task of this project is to identify what quality components have to be used in analyzing program outcomes. Controlling mortality rates, as with any other program in nursing care, is based on three factors: nursing training (knowledge), performance (activities), and patient attitudes (satisfaction) (Ball, 2017). In other words, there is an expectation to evaluate what nurses know about their roles and goals, how they complete their tasks, and what patients and their families think about the care offered.
Patient satisfaction is one of the components of care quality in nursing. Some many tools and instruments can be used to enable quality measurement. In program evaluation, a component can be evaluated through the results of the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) developed by Canadian researchers or the Quality from Patients’ Perspective (QPP) introduced by nurses in Sweden (Glarcher et al., 2015). The Nurses Assessment of Quality Scale-Acute Care Version (NAQS-ACV) is an instrument that checks the quality of care from the nurses’ perspective (Glarcher et al., 2015). Nurses should also introduce the goals and outcomes they desire to see if all of them are achieved at the end of a program. Finally, the activity component presents information about the desired and actual duration of activities, the conditions under which nurses have to work, and the opportunities available to nurses.
Conclusion
In general, this project shows that the role of quality and safety cannot be ignored in nursing science. These measures have to be monitored and developed depending on patients’ expectations, the outcomes already achieved, available resources, knowledge, and future goals. Nursing is a constantly developing field where the exchange of knowledge and experience contributes to positive patient outcomes and the improvement of care quality and the safety of patients. There are many examples of how to apply quality and safety measures in nursing science, and outcome evaluation is one of the best methods to verify the effectiveness of this measurement.
References
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