NUR 621 Identify two quality metrics used in your clinical workplace

NUR 621 Identify two quality metrics used in your clinical workplace

NUR 621 Identify two quality metrics used in your clinical workplace

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Identify two quality metrics used in your clinical workplace. How are these measured and are the results shared with the nursing staff? If not, do you think they should be? What would be the benefit?

 

There are several quality measures used in healthcare. The measures used to assess and compare the quality of health care organizations are classified as either a structure, process, or outcome measure. “Structural measures give consumers a sense of a health care provider’s capacity, systems, and processes to provide high-quality care. Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition. These measures typically reflect generally accepted recommendations for clinical practice. Outcome measures reflect the impact of the health care service or intervention on the health status of patients.” (Agency for Healthcare Quality and Research, 2021)

 

One quality metrics used in the VA is Mission Act Quality Standards comparison data. This allows consumers to examine VA and regional community provider performance on key clinical quality and experience metrics. This metric aids patients in understanding the quality of care available in their geographic region. The metrics included indicators of inpatient, outpatient, and patient experience performance that align with three central tenants of VA care. “Effective care is based on scientific knowledge of what is likely to provide benefit to veterans, Safe Care that avoids harm from the care that is intended to help veterans, and veteran -centered care that anticipates and responds to Veterans and their caregivers.” (United States Department of Veterans Affairs, 2021). The quality metrics are measured by surveys and evaluation of weekly incident reports. The information is shared with nurses via the monthly townhall meetings, electronic mail, and weekly news letters.

 

Another quality metric used at the VA is catheter associated urinary tract infection rates. The number of patients who contract UTI’s during their inpatient stay that have indwelling catheters is measured daily. The system keeps track of everyone in the facility that has a catheter and charts are audited daily to see if CHG baths were performed. Cultures and labs are consistently drawn to evaluate the range of WBC’s and possible signs of infection. The results are shared with staff on a monthly basis via e-mail and in monthly town hall meetings.

 

Overall, I think that having quality metrics is a benefit to the VA system. Quality metrics helps to keep us aware of areas of improvement as well as areas that are doing well. It is important to consistently perform evaluations to maintain a high level of quality service.

 

Mission Act Quality Standards. (2021). United States Department of Veterans Affairs. http//:accesstocare.va.gov

 

Types of Healthcare Quality Measures. (2021). Agency for Healthcare Quality and Research. http://ahrq.gov

 

I am employed in day surgery and we are currently tracking operating room (OR) efficiency by monitoring surgical start times and as well as surgical site infections (SSIs). The OR is responsible for generating revenue for healthcare organizations around the world but is also one of the most expensive areas to manage according to Gómez-Ríos et al. (2019). Therefore, it is imperative that strategies are implemented to increase efficiency and utilization.

At our facility OR start times and other pertinent data are documented in the VISTA electronic health record. The perioperative nurse manager is responsible for gathering, analyzing, and reporting this information monthly. Unfortunately, dissemination of this information is not always consistent. However, I believe everyone should be fully informed because it is critical in improving on-going processes and patient care.

 

SSIs are responsible for 20% of all hospital-acquired infections (Ban et al., 2017). Surgical site infections are tracked by the VA Surgical Quality Improvement Program (VASQIP) which is part of the VA National Surgery Office (NSO). This department is responsible for reviewing and reporting data on all patients who undergo surgery within the VA healthcare system including its significance and implications for patient care as well as the quality of the care provided. However, this information is reported to leadership, but not to nursing staff unless requested. This is a significant patient safety issue that requires a multidisciplinary approach and therefore, data should be routinely reported and readily accessible to nursing staff.

 

References NUR 621 Identify two quality metrics used in your clinical workplace

 

Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., Itani, K. M., Dellinger, E. P., Ko, C. Y., & Duane, T. M. (2017). American College of surgeons and surgical infection society: Surgical site infection guidelines, 2016 update. Journal of the American College of Surgeons, 224(1), 59-74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029

 

Gómez-Ríos, M., Abad-Gurumeta, A., Casans-Francés, R., & Calvo-Vecino, J. (2019). Keys to optimize the operating room efficiency. Revista Española de Anestesiología y Reanimación (English Edition), 66(2), 104-112. https://doi.org/10.1016/j.redare.2018.08.011

REPLY

BT

The two-quality metrics used in my workplace are the length of stay and readmission rates. Length of stay measures the amount of time a patient spends in the hospital from the time of admission to time of discharge. The length of stay metric is often traced over weeks and months and in annual quarters. The data collected is important because it provides sufficient evidence on the hospital’s level of care efficiency. Care efficiency contributes significantly to how long a patient stays in the hospital. High care efficiency leads to short hospital stays, while inadequate care efficiency extends the length of patient stay. When patients stay in the hospital for too long, they are at risk for hospital-acquired infections (Baek et al., 2018). The length of stay metric results are shared with the nursing staff. The purpose of sharing the results is to encourage nurses to improve care efficiency to enable short hospital stays.

Readmission rates show the number of patients admitted into the same facility or a different facility within thirty days of being discharged for the same condition. It also tracks a patient’s readmission due to a complication related to the original condition of care. The readmission rate metric measures the quality of care given to patients (Fische et al., 2014). When the number of readmitted patients is high, it indicates that the health professionals are delivering low-quality care to patients, ignoring complications or relevant patient information. Conversely, a small number of readmission cases shows the hospital provides high quality of care.

The results of the readmission rate metric are not shared with the nurses. However, I think that these results should be shared because nurses can help reduce the rate of readmission. Nurses can improve on the quality of care they provide to patients. Moreover, they can carry out patient education on proper scheduling of medication and common illnesses that lead to readmission (Nelson & Rosenthal, 2015). They can also enhance communication with patients to determine whether they need further care to prevent readmission.

References NUR 621 Identify two quality metrics used in your clinical workplace

Baek, H., Cho, M., Kim, S., Hwang, H., Song, M., & Yoo, S. (2017). Analysis of length of hospital stay using electronic health records: A statistical and data mining approach. Plos One, 12(4), e0195901. https://doi.org/10.1371/journal.pone.0195911

Fischer, C., Lingsma, H. F., Marang-van de Mheen, P. J., Kringos, D. S., Klazinga, N. S., & Steyerberg, E. W. (2014). Is the readmission rate a valid quality indicator? A review of the evidence. Plos One, 9(11), e112282.

Nelson, J. M., & Rosenthal, L. (2015). How nurses can help reduce hospital readmissions: learn how to help mitigate readmission risk starting from the time of admission. American Nurse Today, 10(5), S18-S18.

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NUR 621 Identify two quality metrics used in your clinical workplace Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread)	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements per discussion thread	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement per discussion thread	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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