QUALITY INDICATORS NURS 8302
Sample Answer for QUALITY INDICATORS NURS 8302 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.
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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
To Participate in this Discussion:
Week 2 Discussion
A Sample Answer For the Assignment: QUALITY INDICATORS NURS 8302
Title: QUALITY INDICATORS NURS 8302
The nurse-sensitive indicators, patient falls, and readmissions due to medication nonadherence, hold significant relevance for a psychiatric hospital setting. This indicator is sensitive to nursing care because falls often result from factors such as inadequate supervision, environmental hazards, or issues with patient mobility (Oner et al., 2021). In psychiatric care, patient safety is a vital concern, and preventing falls aligns with the broader goal of ensuring a secure and therapeutic environment. Patients in psychiatric hospitals may experience conditions or medications that affect their balance and coordination, making them vulnerable to falls. Implementing strategies like the Morse Fall Scale, as mentioned in your post, can be adapted to assess the fall risk of psychiatric patients. This tool enables healthcare providers to identify individuals at a higher risk of falls and implement tailored interventions to mitigate these risks.
Readmissions due to medication nonadherence directly impact psychiatric care outcomes. Psychiatric patients often require ongoing medication management to stabilize their mental health conditions. In general, 49% of individuals diagnosed with major psychiatric disorders demonstrated non-adherence to their prescribed psychotropic medications (Semahegn et al., 2020). Specifically, the rates of non-adherence for psychotropic medications among patients with schizophrenia, major depressive disorders, and bipolar disorders were 56%, 50%, and 44%, respectively (Semahegn et al., 2020). Medication nonadherence in this context could lead to symptom exacerbation, relapse, or an increased risk of crisis situations. The many factors contributing to medication nonadherence, such as inadequate understanding of medications and difficulty scheduling, are particularly relevant in psychiatric settings. Addressing these issues requires a comprehensive approach involving patient education, simplified medication regimens, and involvement of family members or support systems in the care process.
In a psychiatric hospital setting, the quality indicators highlighted in your post would likely drive quality improvement initiatives. For patient falls, the hospital may implement environmental modifications, staff training programs, and continuous monitoring to enhance patient safety (Baernholdt et al., 2020). In the case of medication nonadherence, psychiatric hospitals could focus on developing patient-centered education programs, employing technology for medication reminders, and promoting collaboration with family members or caregivers to provide additional support (Semahegn et al., 2020). These initiatives not only align with the broader principles of psychiatric care but also contribute to the overall quality of nursing services in the hospital. Addressing these nurse-sensitive indicators ensures a holistic and patient-centered approach in the psychiatric hospital, promoting both safety and therapeutic outcomes.
References
Baernholdt, M., Yan, G., Hinton, I. D., Cramer, E., & Dunton, N. (2020). Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years. International journal of nursing studies, 105, 103455. https://doi.org/10.1016/j.ijnurstu.2019.103455Links to an external site.
Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing-sensitive indicators for nursing care: A systematic review (1997-2017). Nursing open, 8(3), 1005–1022. https://doi.org/10.1002/nop2.654
Semahegn, A., Torpey, K., Manu, A., Assefa, N., Tesfaye, G., & Ankomah, A. (2020). Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Systematic reviews, 9(1), 17. https://doi.org/10.1186/s13643-020-1274-3Links to an external site.
A Sample Answer 2 For the Assignment: QUALITY INDICATORS NURS 8302
Title: QUALITY INDICATORS NURS 8302
The nurse sensitive indicator of medication adherence in the 30 days post hospital discharge is relevant to understanding the opportunity to reduce 30-day readmission to hospitals. There is a two-prong impact of assuring patients understand the medications that are to be continued and discontinued in the home. The first reason is that medication adherence affects the patient’s morbidity and mortality rates especially in the face of an unintended and unplanned hospital readmission (Neiman et al., 2017). The second prong is that 30 day readmission impacts the healthcare system financial reimbursement due to penalties enforced by Medicare (CMS), Managed Medicare and Commercial payers (Pugh et al., 2021).
In my department a quality study was conducted to determine why our 30-day readmission had increased in high-risk populations within the cardiac service line. For all 30-day readmitted patients we utilize a questionnaire that queries the patient experience in the post-hospital discharge with the index (first discharge). Extrapolated data for the population determined that 50% of the patients discharged to home and readmitted to the hospital stated they had issues related to understanding their medications. The statistics are similar to data collected by CDC researchers who report that 25% of new prescriptions are never filled, and among those filled, approximately 50% are taken incorrectly, particularly with regard to timing, dosage, frequency, and duration (Neiman et al., 2017). The financial costs of medication non-adherence costs the United States healthcare system $100 to $300 billion in health care dollars annually (Neiman et al., 2017).
Pugh et al (2017), support evidence based care transitions to reduce 30 day unplanned readmission by actively engaging patients with understanding their discharge plan by eliciting a response by utilizing the ‘teach-back’ method while in the hospital and a post-hospital intervention in the home with a 7-day post-hospital provider visit.
The Care Coordination department at the current practice has started a pilot of assuring high-risk populations receive a 7-day post hospital appointment either with their provider or with and Extensivist group of providers who visit the patient in their home for continued medication reconciliation and education. The goal is to reduce 30 day readmission utilizing a PDSAE (plan-do-study-act-evaluate) model of quality improvement.
References
Neiman, A. B., Ruppar, T., Ho, M., Garber, L., Weidle, P. J., Hong, Y., George, M. G., & Thorpe, P. G. (2017). CDC Grand Rounds: Improving medication adherence for chronic disease management — innovations and opportunities. MMWR. Morbidity and Mortality Weekly Report, 66(45), 1248–1251. https://doi.org/10.15585/mmwr.mm6645a2
Pugh, J., Penney, L. S., Noël, P. H., Neller, S., Mader, M., Finley, E. P., Lanham, H. J., & Leykum, L. (2021). Evidence based processes to prevent readmissions: More is better, a ten-site observational study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06193-x
Rubric Detail
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Content
Name: NURS_8302_Week2_Discussion_Rubric
- Grid View
- List View
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
: 0–69 |
||
| 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