Quality and Sustainability in Nursing Science

The improvement of the quality of healthcare service is one of the priorities for nursing researchers and practitioners. The US healthcare system is characterized by considerable impairments that lead to people’s death, their health deterioration, the country’s financial losses, and the emergence of numerous issues related to public health. For instance, medical error is the third top cause of death in the United States (Sherwood, 2017).

It has been estimated that quality-related issues account for $17-29-billion losses annually (Sherwood, 2017). Researchers and practitioners develop various strategies and projects aimed at improving quality. This paper includes a definition of the concept as it is applied to nursing science, an example of quality measures undertaken as well as quality components to assess healthcare programs’ outcomes.

Several definitions of quality as it applies to nursing science are available as researchers tend to focus on or highlight different sets of aspects. Sherwood (2017) notes that many researchers concentrate on patients’ deaths, medical errors, readmissions as the primary areas related to quality. Some pay more attention to nursing professionals’ performance, leadership, and organizational culture when analyzing quality in health care (Johnson, 2017).

Many studies involve the analysis of patients’ experiences, their attitudes, as well as the way they interact with healthcare practitioners. Quality measures are aimed at addressing the areas mentioned above. It is possible to combine these aspects in order to define quality measures in nursing practice.

Quality measures are strategies, programs, and activities aimed at the provision of nursing services that ensure the best patient outcomes, the improvement of nursing practitioners’ competencies, and leadership. These instruments are also designed and implemented to contribute to the sustainable development of the healthcare system. Some of the most common quality measures include guidelines and checklists for the nursing staff.

Protocols and organizational policies are available at the vast majority of healthcare facilities. Self-monitoring, check-ups, hand hygiene, follow-up calls are also examples of such tools. Schneider et al. (2017) explore the effectiveness of yet another measure that involved networking and the promotion of certain strategies. This project has proved to be effective as the healthcare facilities that participated in the study started using the promoted quality measures. Schumann (2017) claim that data collection and analysis is another important method to assess and improve quality.

All these measures have multiple effects on modern nursing science. First, these measures are analyzed and researched to identify the ways they can be applied in different settings. Secondly, researchers try to develop quality measures based on existing instruments and interventions, as well as theoretical paradigms. Furthermore, the analysis of such quality-related concepts such as patient outcomes and satisfaction, nurses’ leadership and performance, as well as their motivation and burnout contributes to the improvement of the healthcare system. Healthcare programs are evaluated in terms of these measures.

Therefore, it is possible to state that quality measures define the interventions and programs that become integrated into the healthcare system through standards, policies, and regulations. Finally, the assessment of such measures also results in the development of nursing science as various research tools are employed and refined.

One of the illustrations of the way quality measures can be applied in nursing science is the study of follow-up calls. Harrison, Auerbach, Quinn, Kynoch, and Mourad (2014) focus on the relationship between this measure and readmission rates. The researchers utilized quantitative methods to address their research questions. They identified a negative correlation between follow-up calls that were received and readmissions. However, it is also stressed that there is no such relationship between calls that were not received. Apart from assessing a specific quality instrument, Harrison et al. (2014) tried a number of research tools and identified some areas requiring further investigation.

A different aspect related to the use of follow-up calls was the subject matter of another study. Holmström, Nokkoudenmäki, Zukancic, and Sundler (2016) implemented a qualitative study in order to identify older patients’ experiences. The researchers concentrated on the participants’ attitudes towards the effectiveness of follow-up calls. It was found that older patients were largely satisfied with the experience and felt safer (Holmström et al., 2016). Even when the accessibility of the service was limited or some issues were encountered, the participants tended to place a high value on the service. Again, one of the contributions of this study to nursing science included the use of certain research instruments. Holmström et al. (2016) utilized content analysis and purposive sampling that can be applied in similar studies.

As mentioned above, nursing science provides tools to assess the healthcare programs aimed at quality improvements. Researchers have also identified a set of areas of major concern. Quality-related components necessary for the evaluation of a program include but are not confined to its fit to the purpose, adverse effects, cost-effectiveness, stakeholders’ attitudes, system-related outcomes (Welch, 2017).

One of the central components of the assessment is whether the program has achieved the established goals (Walton & Barnsteiner, 2017). It is also necessary to consider the efficiency of the methods utilized to achieve the goals, as well as the cost-effectiveness of the project. In many cases, people’s attitudes and experiences are regarded as less important when evaluating programs and interventions. Nevertheless, this component is instrumental in ensuring the high motivation of the participants as people who have a negative attitude towards an intervention are unlikely to perform or interact properly. The lack of motivation can result in financial losses or inadequate results of the assessment.

It is also necessary to note that the choice of the most appropriate assessment tools depends on the focus of the evaluation. Data collection can take the form of documentation analysis or interview. For instance, if nurses’ performance improvement is the purpose of the program, evaluators can analyze reports, the rate of medical errors, the level of patient satisfaction, and other variables. This assessment will involve the analysis of health records, reports, and surveys. At the same time, another component of this quality assessment can be the use of questionnaires and interviewing. Evaluators can analyze nursing professionals’ opinions concerning the program, which can shed light on the reasons behind their good or bad performance.

In conclusion, quality is one of the priorities of healthcare practitioners and researchers. Various programs aimed at improving quality appear. The projects address various aspects related to quality in nursing practice. The evaluation of these programs has diverse effects on nursing practice and science. For instance, researchers identify the most effective elements and ways they can be applied in different settings. Every evaluation and study also contributes to the development of nursing science as effective research instruments are used. Researchers refine the existing research instruments and theoretical frameworks and come up with new ones.

References

Harrison, J. D., Auerbach, A. D., Quinn, K., Kynoch, E., & Mourad, M. (2014). Assessing the impact of nurse post-discharge telephone calls on 30-day hospital readmission rates. Journal of General Internal Medicine, 29(11), 1519-1525. Web.

Holmström, I. K., Nokkoudenmäki, M. B., Zukancic, S., & Sundler, A. J. (2016). It is important that they care – older persons’ experiences of telephone advice nursing. Journal of Clinical Nursing, 25(11-12), 1644-1653. Web.

Johnson, J. (2017). Quality improvement. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (pp. 109-130). Hoboken, NJ: John Wiley & Sons.

Schneider, E. C., Sorbero, M. E., Haas, A., Ridgely, M. S., Khodyakov, D., Setodji, C. M.,… Goldman, D. (2017). Does a quality improvement campaign accelerate take-up of new evidence? A ten-state cluster-randomized controlled trial of the IHI’s Project JOINTS. Implementation Science, 12(1). Web.

Schumann, M. J. (2017). Policy implications driving national quality and safety initiatives. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (pp. 21-42). Hoboken, NJ: John Wiley & Sons.

Sherwood, G. (2017). Driving forces for quality and safety: Changing mindsets to improve health care. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (pp. 3-20). Hoboken, NJ: John Wiley & Sons.

Walton, M. K., & Barnsteiner, J. (2017). Patient-centered care. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (pp. 61-84). Hoboken, NJ: John Wiley & Sons.

Welch, J. (2017). The patient within the critical care environment. In S. Adam, S. Osborne, & J. Welch (Eds.), Critical care nursing: Science and practice (pp. 41-82). New York, NY: Oxford University Press.