How do you define quality as it pertains to health care and the practice of nursing? Some nurses may define quality as effective interdisciplinary teamwork that results in better patient-health outcomes, while hospital administrators may define quality as appropriately delegated responsibilities, completion of tasks, and effective patient flow. Due to the subjective nature of the term, quality is a topic of great debate.
 

In an effort to define quality in health care, standards have been developed to establish consistency and provide guidance. The National Database of Nursing Quality Indicators (NDNQI) outlines nursing-sensitive indicators that encompass measurement scales for quality of nurse professionals as well as quality of the services provided by nurses to patients. In this week’s Discussion, you evaluate the determinants of quality.m based on the NDNQI indicators and the theoretical underpinnings of these quality indicators. You apply nursing-sensitive indicators to your current setting and assess how each definition of quality contributes to the idea of quality overall.
 

• Review      the NDNQI indicators presented in the Learning Resources that emphasize      quality. Focus on those indicators that pertain to your practice setting (Hospital).
• 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 that      discuss how quality indicators influence your practice setting.
• Select      one definition of quality published by any peer-reviewed source that      particularly resonates with your thinking about quality.

post a cohesive scholarly response that addresses the following:

1) Identify two nurse-sensitive indicators of quality that relate to patient care and analyze the influence of early quality improvement theories and philosophies on the development of those indicators.  For this exercise, do not choose nurse sensitive indicators that relate to staffing levels. 

2) Find and cite at least 2 nursing research articles you located and evaluate how these indicators influence a practice setting (See attached PDF for the 2 Articles).

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 3: “Variation in Medical Practice and Implications for Quality”

Chapter 4: “QI Foundation, Processes, Tools and Knowledge Transfer Techniques”

Chaboyer, W., Johnson, J., Hardy, L., Gehrke, T., & Panuwatwanich, K. (2010). Transforming care strategies and nursing-sensitive patient outcomes. Journal of Advanced Nursing, 66(5), 1111–1119. doi: 10.1111/j.1365-2648.2010.05272.x

The authors of this article attempt to reduce medication errors, patient falls, and ulcers by using Transforming Care at the Bedside, which is a framework that values safety and reliability, creates a good work environment, is centered on the patient, and increases value. They conclude that these principles are able to positively affect their patients, but some aspects of the study may be inconclusive.

Gerritsen, D.L., & van Beek, A. P. A. (2010). The relationship between organizational culture of nursing staff and quality of care for residents with dementia: Questionnaire surveys and systematic observations in nursing homes. International Journal of Nursing Studies, 47(10), 1272–1282.

After briefly discussing the background of organizational culture, the study in this article focuses on how organizational culture affects quality of care in long-term care. It uses two independent measurements and determines that different styles of organizational culture affect the quality of care.

The American Nurses Association, Inc. (2011). Nursing-sensitive indicators. Retrieved from http://web.archive.org/web/20120921021800/http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/PatientSafetyQuality/Research-Measurement/The-National-Database/Nursing-Sensitive-Indicators_1.aspx

From the American Nurses Association, this article discusses nursing-sensitive indicators. It provides a definition of the term and then describes the development process and indicator list.

American Nurses Association. (2011). National Database of Nursing Quality Indicators. Retrieved from http://www.nursingworld.org/

This website acts as a database for unit-specific nurse-sensitive information that comes from multiple health care organizations.

Agency for Healthcare Research and Quality. (n.d.) Retrieved from http://www.ahrq.gov/

The provided link takes you to the homepage of the Agency for Healthcare Research and Quality (AHRQ), where you can find information about improving safety and quality in the health care industry.

National Quality Forum. (2011). Retrieved from http://www.qualityforum.org/Home.aspx

Various members of the health care community can become members of the National Quality Forum (NQF) through this site. The nonprofit organization NQF aims to increase quality improvement for its members. 

1. Storer Brown, D. (2016). Perspectives in Ambulatory Care. Ambulatory Care Nurse-Sensitive Indicators Series: Reaching for the Tipping Point in Measuring Nurse-Sensitive Quality in the Ambulatory Surgical and Procedure Environments. Nursing Economic$, 34(3), 147-151.

2. Wilson, M. (2011). Addressing the problems of long-term urethral catheterization: Part 1. British Journal Of Nursing (Mark Allen Publishing), 20(22), 1418.