professional nursing exam 2

relevance of nursing research

-provides a scientific foundation for nursing practice
-helps validate current practices and introduces improvements
-enhance patient outcomes

early developers in quality improvement

-Florence Nightingale
- American College of Surgeons (ACS)
-Hospital Standardization Program (HSP)
-The Joint Commission: Joint Commission Standards
-National Patient Safety Goals
-Quality assurance (QA) programs

Quantitative Research

-Seeks to identify specific factors for desired outcomes or confirm theory through explanation Focuses on objectivity and relies upon numerical operation to explain and make predictions

Qualitative research

Aims to discover, deeply understand, and find meaning in human subjective experiences Personal narratives and observational descriptions serve as data sources

hypotheses

-not used in qualitative research -in quantitative studies, they are tested statistically in relation to the laws of chance

Ethnography

method designed to describe culture

Grounded theory methodology

seeks to outline basic social process or generate new theory based on participant data

evidence based practice

Practice based on the best available evidence that also incorporates client values and preferences and clinical judgment and expertise

research utilization

Systematic process to incorporate research study findings into clinical practice

Factors that block or impede use of researchfindings in clinical practice

Nursing practice Personal attitudes
Failure to understand statistics

Scholar

intellectual who has undertaken advanced study in a given field

National Institute for Nursing Research (NINR

-Identifies nursing research priorities
-Distributes grants to nurse researchers
-Disseminates nursing research findings to health professionals and the public

quality health care

Safe
Timely
Efficient
Equitable
Effective
Patient-centered

evidence based practice integrates

patient values.
current research.
clinical expertise.

Independent variable

Variable purposefully manipulated by the researcher to have a direct effect on anothervariable

Dependent variable

Variable that is observed, measured, and presumed to be influenced by or related in some special way to the independent variable

Probability statistics (level of significance)

used to determine likelihood that relationship between variables results from something other than chance

Descriptive design

answers questions about the nature of presently occurring events

Experimental design

test the effects of manipulating one or more variables

Historical design

describes or evaluates past events

Ethnographic research

acts as a member of an observed group

Illustration

identify qualitative examples of quantitative variables

Instrumentation

collects data for developing an instrument

Theory building

explaining a phenomenon

Mixed-methods research studies

Combine quantitative and qualitative research methods within a single study

Research ethics

-Assure truth in scientific studies -Protect the human rights of participants
-Balance the risks and benefits of a study
-Prevent exploitation of vulnerable individuals

Institutional Review Board (IRB)

Meets on a regular schedule to review research proposals, verify that investigators have considered research ethics, and ensure the study meets scientific standards

steps in ebp

1. Ask a clinical question.
2. Search for the most relevant and best evidence
3. Critically appraise the evidence.
4. Apply the evidence to practice
5. Evaluate the outcomes
6. Communicate and disseminate results.

importance of ebp for the nursing profession

-promotes high quality, cost effective care
-advances nursing knowledge and practice
-reduces errors

research

a systematic investigation aimed at generating new knowledge or validating existing information.
Goal: Create new evidence for healthcare practice.

Quality Improvement (QI)

A continuous process that evaluates healthcare delivery and implements changes to improve patient outcomes.
Goal: Enhance processes and reduce healthcare errors
-synonymous with quality assurance

Total quality management

Uses fundamentals based on scientific management emphasizing fact-based management and management becoming the master of facts by collecting information

comparison

EBP uses Research to guide clinical practice, while QI focuses on improving care within established frameworks by applying small, iterative changes.

APA as the Format for Professional Writing in Nursing

APA (American Psychological Association) format is a standardized writing style used in nursing and other health sciences.

Key Components of APA

Title Page: Includes the title of the paper, author, institution, and date.

In-Text Citation: Cite sources within the text, typically (Author last name, Year).

Reference List: A detailed list of all sources cited, in alphabetical order.

Plagiarism

Using someone else's work without proper citation is considered academic dishonesty.
Always credit sources to avoid plagiarism.

Blame-Free Culture of Safety in Healthcare

A blame-free culture encourages healthcare professionals to report errors or near-misses without fear of punishment.

Critical Concerns in Healthcare Safety

Medication errors, surgical mistakes, and patient falls

Examples of Safety Initiatives

root cause analysis, checklists, team STEPPS

Root Cause Analysis (RCA)

Identifies the underlying causes of safety incidents.

Checklists

Standardized checklists (e.g., for surgeries) to ensure safety.

Team STEPPS

Promotes teamwork and communication to prevent errors

National Quality Strategy

A government initiative aimed at improving the quality of healthcare in the U.S

National Quality Strategy goals

Better care.
Healthy people and communities.
Affordable care

Total Quality Management (TQM)

Uses fundamentals based on scientific management emphasizing fact-based management and management becoming the master of facts by collecting information

The Institute of Medicine's Quality Chasm Series

Nurses should practice to the full extent of their education and training
-nurses should schieve higher levels of education/training
--should be full partners with other health professionals

National Quality Forum (NQF

A nonprofit, private, nonpartisan, membership-based organization that works to catalyze improvements in health care

w edwards deming

father of the quality improvement movement

joseph juran

Quality Control Handbook, 1951
Viewed quality as fitness-for-use
Quality trilogy- quality planning, quality control, quality improvement

philip crosby

Wrote Quality is Free; he emphasized the complete elimination of failures to save money, as most firms underestimate their failure costs and should evaluate all costs of quality; "Do it right the first time".

walter a shewhart

Father of statistical quality control

experience based codesign

method of designing better experiences for patients, carers and staff.

benchmarking

the process of measuring products, services, and processes against those of organizations known to be leaders in one or more aspects of their operations.

CQI programs

Look for opportunities to change processes ofhealth care delivery to improve safety,effectiveness, client focus, and efficiency

Which statement best describes Total Quality Improvement(TQI)

Seeks to improve constancy in actions while meeting (and exceeding) product and service standards

the leapfrog group

Not-for-profit watchdog organization that drives movement by proposing big leaps toward improving the American health care system

Quality and Safety Education in Nursing (QSEN)

Patient-centered care, teamwork andcollaboration, evidence-based practice, QI,safety, and informatics

Examples of High-Risk Healthcare Activities

Medication administration, care transitions, and surgeries

QI Theories to Monitor and Improve Healthcare

six sigma, Deming Cycle (PDCA), IOM Chasm Series

Six Sigma

Focuses on reducing process variations and improving quality
-developed to sharpen its focus on QI and help accelerate the pace of change in highly competitive markets

six sigma steps

Define, Measure, Analyze, Improve, Control

define

identify the problem, determine requirements, and set goals

Measure

validate the problem or flawed process, refine problems or goals, and measure key stapes and outputs

analyze

develop casual hypotheses, identify the vital few root causes and validate a casual hypothesis

improve

develop ideas to eliminate root causes, test solutions, standardize to a single solution, and measure results

Control

establish standard measurements to maintain performance and correct problems as needed

Deming Cycle (PDCA)

Plan-Do-Check-Act cycle for continuous improvement

IOM Chasm Series

Institute of Medicine's reports outlining gaps in U.S. healthcare and strategies for improvement.

Tools to Monitor and Improve Healthcare

Root Cause Analysis.
PDSA (Plan-Do-Study-Act) Cycles.
Clinical Audits

Individual care

Focuses on holistic care of the person.

Family care

Care involves the support systems around the patient.

Community care

Focuses on the health of populations and public health initiatives.

Person-Centered Care

Tailors healthcare to the individual's preferences and needs.

Family-Centered Care

Involves the family in care planning and decision-making.

Primary prevention

Preventing disease (e.g., vaccinations)

Secondary prevention

Early detection and treatment (e.g., screenings).

tertiary prevention

Reducing disease impact through rehabilitation

Relationship to Nursing

Ensures that care is individualized and respectful of patients' preferences and values.

Importance of Consumerism in Healthcare

Patients are now more informed and demand transparency, quality, and value in healthcare services

Culture, Diversity, and Disparities

Culturally competent care is crucial for reducing health disparities and ensuring equitable care.

Nurses' Role in Care Coordination

Nurses act as advocates, ensuring seamless transitions between different healthcare settings

Patient Advocacy: Nurses protect patients’ rights and ensure their voices are heard.

Power in Nursing

Nurses have influence over patient care decisions and must advocate for safe and effective care

Empowerment

Involves providing nurses with the tools, knowledge, and authority to act in the best interest of the patient.

Knowledge and Competencies for Effective Team Functioning

Collaboration, communication, and conflict resolution skills are essential for functioning within healthcare teams.

informatics

Deals with the collection, classification, storage, retrieval, and dissemination of recorded knowledge treated both as a true and applied science

Health Informatics

Health informatics combines healthcare with technology to improve patient outcomes and streamline healthcare delivery.

New Approaches in Informatics

Telehealth, electronic health records (EHRs), and data analytics for personalized care.

Electronic Health Record (EHR)

stores client health information digitally in a secure database

putting clients first

initiative from National Health Council calls for health information to be portable, belong to the client, and empower the client to make informed decisions regarding care

four categories of medical health care informatics

clinical research informatics
consumer health informatics
public health informatics
translational bioinformatics

clinical research informatics

relates to informatics whose objective is to advance the biomedical/health sciences through the humane and ethical use of informatics

consumer health informatics

study of patient use of online information and communication to improve health outcomes and decisions

translational bioinformatics

the science of collecting, representing, storing, retrieving, and processing data and knowledge for improving human health

Purpose of Documentation

Accurate documentation ensures continuity of care, legal protection, and quality reporting

Informatics Nurse Specialist

Has a graduate education, advanced levels of computer and information literacy, and professional development in leadership

public health informatics

the systematic application of information and computer science and technology to public health practice, research, and learning

Key Issues in Informatics

Meaningful Use: Ensuring that EHRs are used to improve patient outcomes.

HIPAA: Protects patient confidentiality and regulates the sharing of personal health information

High-Touch Care

Emphasizes empathy, communication, and the personal connection between nurse and patient

High-Tech Care

Utilizes technology to enhance healthcare delivery but requires a balance to maintain the human element in care.

consumer health informatics focuses on

delivering healthcare services to persons who need or want services