NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Sample Answer for NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC Included After Question
Florence Nightingale introduced research to the field of nursing, and with this introduction, a focus on improving patient care has continued to be at the forefront of nursing practice. Improving patient care lends itself to the study of quality care and patient safety, and nurse-sensitive quality indicators highlight the elements of healthcare in which patients are directly impacted by the care provided by nurses.
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What are nurse-sensitive indicators? What elements of a patient’s care are directly impacted by the role and delivery of care of nurses? How might these nurse-sensitive indicators change healthcare delivery and the nursing profession for a future DNP-prepared nurse?
For this Discussion, you will explore your understanding of nurse-sensitive indicators of quality by reflecting on those quality indicators that may pertain most to your practice setting. You will conduct a literature search for articles that address these quality indicators and reflect on the connections between the quality indicators and quality improvement theories and philosophies.
To Prepare:
- Review the Learning Resources on quality indicators for this week. Focus on those quality indicators that most pertain to your practice setting.
- Consider the influence of early quality improvement theories and philosophies on the development of those quality indicators.
- Using the Walden Library, locate at least two scholarly research articles to focus on, for this Discussion, that discuss how quality indicators may influence your practice setting.
- Select one definition of quality published by any peer-reviewed source that particularly resonates with your thinking about quality.
- Identify and select at least two nurse-sensitive indicators of quality related to patient care. Note: Do not select nurse-sensitive indicators related to staffing.
By Day 3 of Week 2
Post a brief description of the two nurse-sensitive indicators of quality that you selected. Analyze the influence of early quality improvement theories and philosophies on the development of the quality indicators you selected. Be specific. Then, cite the two (2) nursing research articles you selected, and explain how these indicators may influence your practice setting. Be specific and provide examples.
By Day 6 of Week 2
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding on your colleague’s post and explaining how the quality indicators selected by your colleague may influence your practice setting.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
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Week 2 Discussion
A Sample Answer For the Assignment: NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Title: NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Florence Nightingale introduced research to the nursing field, and research has continued to be at the forefront of nursing practice. Nurse-sensitive indicators are influenced by nursing care, including patient falls, hospital-acquired pressure ulcers, catheter-associated urinary tract infections (CAUTI), and central line associated blood stream infections (CLABSI). This discussion will tackle patient falls and hospital-acquired pressure injuries.
Fall prevention is a system and study of strategies for preventing accidental falls by older people. Falls are not only more common in older adults than the general population, older adults also have more severe implications like osteoporosis (Kte, 2023). When older adults fall, any injury can be considered more serious than it would have been due to longer healing time, weaker immune system, etc. Heightened risk for fall include gait abnormalities, balance problems, impaired vision and cognition, and a previous history of fall.
Morse Fall Scale is what can be used to assess fall risk. As of 2017, the assessment consists of six risk factors: history of falling, secondary diagnosis, ambulatory aid, IV, gait, and mental status (Kte, 2023). There are several strategies for fall prevention. Older adults should list all the prescription and over-the-counter (OTC) medications and then review the list with their doctor so they can go over side effects and possible interactions. Handrails and grab bars could be installed in bathrooms and stairs. Nonslip mats can be added to bathtubs and showers. Good lighting can help patients with degrading vision. Patients can receive walkers, canes, non-slip socks, and more.
Another nurse-sensitive indicator is hospital-acquired pressure injuries (HAPI); HAPIs seriously affect patients’ prognosis and quality of life (Zhou et al., 2023). Pressure injuries are enduring complications of hospitalization. The initial assessment or upon transfer with Braden Scale score is vital in preventing pressure injuries (Fulbrook & Lovegrove, 2023). Turn team, which should come around every two hours while in bed and every 15-20 minutes in chair, should be implemented. Incontinence management or toileting should be scheduled. Check on the patients during turn team to see if they need to be changed.
References:
Fulbrook, P., & Lovegrove, J. (2023). Reporting accuracy of pressure injury categorisation in an acute tertiary hospital: A four‐year analysis. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 32(17/18), 6403–6414. https://doi.org/10.1111/jocn.16662
Kte, pi, B. M. (2023). Fall prevention. Salem Press Encyclopedia of Health.
Zhou, Y., Yang, X., Ma, S., Yuan, Y., & Yan, M. (2023). A systematic review of predictive models for hospital-acquired pressure injury using machine learning. Nursing open, 10(3), 1234–1246. https://doi.org/10.1002/nop2.1429Links to an external site.
A Sample Answer 2 For the Assignment: NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Title: NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Thank you for your post. Your post is fascinating, and I learn much from it. As you have noted, injuries to the skin and other underlying tissues brought on by prolonged pressure on the skin are referred to as pressure ulcers, bedsores, or pressure sores. Pressure ulcer rates are a measure, analysis, and assessment of the incidence and prevalence of pressure ulcers among patients that are relevant to nurses. According to Kleinpell et al. (2019), this quality indicator is crucial since it shows how well nurse prevention works to prevent and treat pressure ulcers.As you have seen, another crucial nurse-sensitive quality measure is patient falls with injury rates. This metric aids in the assessment of the quantity of patient falls that cause injuries. According to Spano-Szekely et al. (2019), this quality indicator is crucial because it shows how well nurse prevents and manages falls and safety precautions. You have accurately analyzed how early ideas and theories of quality improvement influenced the creation of the aforementioned quality indicators. TQM (Total Quality Management), as you have noted, places a strong emphasis on the value of cooperation, teamwork, and continual quality improvement. According to this idea, nurse-sensitive indicators have been created by highlighting the importance of nurses in providing the best care possible as well as ongoing observation and enhancement of healthcare results (Xu, Kane & Arling, 2019). Donobedian’s quality model, which emphasizes the value of evaluating process and outcome indicators to evaluate and enhance the quality of care, is also crucial for the creation of nurse-sensitive quality indicators.You have also given careful consideration to how these quality indicators may affect your nursing practice in your analysis. You will be in a better position to evaluate the efficacy of interventions, implement fall prevention measures, implement pressure ulcer prevention strategies, encourage collaborative care, and promote ongoing quality improvement in the healthcare industry if you rely on these quality indicators (Kleinpell et al., 2019).
References
Kleinpell, R., Blot, S., Boulanger, C., Fulbrook, P., & Blackwood, B. (2019). International
critical care nursing considerations and quality indicators for the 2017 surviving
sepsis campaign guidelines. Intensive care medicine,45, 1663-1666.
Spano-Szekely, L., Winkler, A., Waters, C., Dealmeida, S., Brandt, K., Williamson, M., … &
Wright, F. (2019). Individualized fall prevention program in an acute care setting: an
evidence-based practice improvement. Journal of nursing care quality,34(2), 127-132.
Xu, D., Kane, R., & Arling, G. (2019). Relationship between nursing home quality indicators
and potentially preventable hospitalization.BMJ quality & safety, 28(7), 524-533
A Sample Answer 3 For the Assignment: NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Title: NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC
Quality Indicator 1 – Pressure Ulcer Prevalence and Incidence
Nurses pay attention to pressure ulcers or bedsores. A pressure ulcer is a tiny skin and/or tissue damage caused by pressure, shear, or both. Pressure ulcer incidence and prevalence are essential for assessing prevention strategies and nursing treatment. Pressure ulcer indicators were influenced by the Donabedian model and other early quality improvement theories that evaluated healthcare structure, method, and outcomes (Chen, Liao, & Zhou, 2023). This pressure ulcer prevention paradigm prioritizes outcomes, which patients need.
Influence of Early Quality Improvement Theories:
Pressure ulcer indicators are shaped by the Donabedian approach, which emphasizes comprehensive quality evaluation. Structures (such as resources and staff), processes (such as preventative measures), and results (such as pressure ulcer prevalence and incidence) are examined. As part of a complete pressure ulcer prevention strategy, the model emphasizes how these factors interact and affect patient outcomes.
Nursing Research Article:
Taylor, Mulligan, and McGraw’s article “Barriers and enablers to the implementation of Evidence-based Practice in pressure ulcer prevention and management in an integrated community care setting” (2021) explores factors affecting the adoption of evidence-based practices in pressure ulcer prevention. This research is relevant to my profession since it sheds light on pressure ulcer prevention challenges and opportunities. The study’s findings could help my company enhance quality by revealing issues like finances and personnel education.
Quality Indicator 2 – Patient Falls
Nurses also include patient falls when assessing nursing care quality and safety. Falls can cause injuries and impact patient outcomes. Fall indicators are influenced by Deming’s PDSA cycle, which emphasizes repeating cycles of planning, doing, studying, and acting to enhance quality (Brandrud, 2019).
Influence of Early Quality Improvement Theories:
The PDSA cycle has advanced fall indicators by promoting a deliberate and iterative quality improvement technique. Continuous outcome evaluation allows nursing interventions to be implemented, evaluated, and adjusted to avoid falls. Constant improvement and adaptability increase nursing care and patient safety.
Nursing Research Article:
The study “Quality Indicators for the care and Outcomes of adults with atrial fibrillation” by Arbelo et al. (2021) highlights quality indicators in patient care, but not specifically in falls. It shows how quality indicators are used in healthcare. This and similar studies can inspire interdisciplinary teams to establish comprehensive quality improvement initiatives to prevent patient falls in my practice using proven strategies from other areas.
To summarize, the creation of nurse-sensitive indicators necessitates comprehension and use of early quality improvement ideas. The selected papers provide valuable insights into the challenges and opportunities for improving patient care and preventing pressure ulcers. These criteria are essential for guiding quality improvement programs to ensure that patients receive high-quality nursing care.
Reference:
Arbelo, E., (Chair), Aktaa, S., Bollmann, A., D’Avila, A., Drossart, I., … & Martins Oliveira, M. (2021). Quality indicators for the care and outcomes of adults with atrial fibrillation: task force for the development of quality indicators in atrial fibrillation of the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC): developed in collaboration with the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS). EP Europace, 23(4), 494-495.
Brandrud, A. S. (2019). Learning about the conditions for improvement and excellent care from high performing clinical networks.
Chen, X., Liao, P., & Zhou, Y. (2023). Construction of nursing-sensitive quality indicators for the care of patients with prone position ventilation using the Delphi method. BMC nursing, 22(1), 336.
Evangelou, E., Middleton, N., Kyprianou, T., Kouta, C., Merkouris, A., Raftopoulos, V., … & Lambrinou, E. (2021). Nursing quality indicators for adult intensive care: a consensus study. Nursing in Critical Care, 26(4), 234-243.
Taylor, C., Mulligan, K., & McGraw, C. (2021). Barriers and enablers to the implementation of evidence‐based practice in pressure ulcer prevention and management in an integrated community care setting: A qualitative study informed by the theoretical domains framework. Health & Social Care in the Community, 29(3), 766-779.
Rubric Detail
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Content
Name: NURS_8302_Week2_Discussion_Rubric
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
: 0–69 |
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| Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
Points Range: 40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. |
Points Range: 35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. |
Points Range: 31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. |
Points Range: 0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. |
|
| Main Posting:
Writing |
Points Range: 6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
Points Range: 5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
Points Range: 4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
|
| Main Posting:
Timely and full participation |
Points Range: 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date. |
Points Range: 8 (8%) – 8 (8%)
Meets requirements for full participation. Posts main Discussion by due date. |
Points Range: 7 (7%) – 7 (7%)
Posts main Discussion by due date. |
Points Range: 0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date. |
|
| First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
|
| First Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
Points Range: 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
Points Range: 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
|
| First Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
Points Range: 3 (3%) – 3 (3%)
Posts by due date. |
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
|
| Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
|
| Second Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
Points Range: 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
Points Range: 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
|
| Second Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
Points Range: 3 (3%) – 3 (3%)
Posts by due date. |
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
|
| Total Points: 100 | |||||
Name: NURS_8302_Week2_Discussion_Rubric
NURS 8302 WEEK 2 Discussion Quality Indicators INSTRUCTIONS PLUS RUBRIC Grading Rubric Guidelines
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
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| 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 |
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| 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) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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| 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 |
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| 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. |