1
|
Ledbeter L. Self-efficacy in Quality Improvement Competency of Frontline Acute Care Registered Nurses. J Nurs Care Qual 2024; 39:168-174. [PMID: 37751558 DOI: 10.1097/ncq.0000000000000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND Registered nurses (RNs) are attuned to health care quality and safety concerns but may lack competency in quality improvement (QI) to advance care quality. PURPOSE To describe frontline acute care RNs' self-efficacy in QI competencies, evaluate differences based on educational attainment, and evaluate relationships based on years of RN experience. METHODS The study used a descriptive, quantitative, correlational, comparative cross-sectional survey design to evaluate RNs' self-efficacy in QI competency using the 2021 American Association of Colleges of Nursing The Essentials : Core Competencies for Professional Nursing Education . RESULTS Frontline RNs' overall QI self-efficacy showed variability in knowledge, skills, and attitudes, with no relationship between self-efficacy and years of RN experience, nor difference based on educational attainment. CONCLUSIONS Insufficient self-efficacy signals the need for further QI focus in nursing education, nursing practice, and health care policy to harness RNs' ability to advance care outcomes.
Collapse
Affiliation(s)
- Lauri Ledbeter
- Author Affiliations: Providence Health & Services, Spokane, Washington
| |
Collapse
|
2
|
Young L, Vogelsmeier A. Quality Dashboards in Hospital Settings: A Systematic Review With Implications for Nurses. J Nurs Care Qual 2024; 39:188-194. [PMID: 37782907 DOI: 10.1097/ncq.0000000000000747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
BACKGROUND Dashboards visually display quality and safety data to aid nurses in making informed decisions. PURPOSE This systematic review evaluated quality improvement (QI) dashboard characteristics associated with interventions to improve patient outcomes and positive end-user evaluation. METHODS Literature was searched from 2012 to 2022 in PubMed, CINAHL, Scopus, MEDLINE, and Google Scholar. RESULTS Sixteen articles were included. Varied dashboard characteristics were noted, with mixed patient outcomes and end-user responses. Graphs and tabular presentations were associated with improved patient outcomes, whereas graphs were associated with end-user satisfaction. Benchmarks were noted with improved patient outcomes but not end-user satisfaction. Interactive dashboards were important for end users and improved patient outcomes. CONCLUSION Nurses can find dashboards helpful in guiding QI projects. Dashboards may include graphs and/or tables, benchmarks, and interactivity but should be useful, usable, and aligned to unit needs. Future research should focus on the use of quality dashboards in nursing practice.
Collapse
Affiliation(s)
- Lisa Young
- University of Missouri School of Nursing, Columbia, Missouri
| | | |
Collapse
|
3
|
QUALITY IMPROVEMENT IN THE GASTROENTEROLOGY SETTING: HOW ARE WE DOING? Gastroenterol Nurs 2023; 46:425-427. [PMID: 38064421 DOI: 10.1097/sga.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
|
4
|
Rodríguez-González R, Martínez-Santos AE, De La Fuente NV, López-Pérez ME, Fernandez-De-La-Iglesia JDC. Identifying engagement and associated factors in nursing students: An exploratory study. J Prof Nurs 2023; 48:77-83. [PMID: 37775245 DOI: 10.1016/j.profnurs.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Burnout and engagement in health students surpass work life. Although levels of burnout in Nursing students are high, academic engagement is an understudied topic in Nursing, which has shown benefits. The aims were to know the level of engagement of Nursing students and to identify factors that prompt higher levels of engagement. METHODS An exploratory study was conducted during 2019 in three Universities in Spain. The UWES-S-17 questionnaire was used. RESULTS The sample consisted of 808 Nursing students. An average level of engagement was found. Engagement differed significantly by gender and age, with females and older students showing greater attitudes. Participants in the second year showed lower scores in the willingness to dedicate effort and persistence than those in the first and third year (p < 0.05). CONCLUSIONS The identification of the level of engagement and factors involved are an opportunity to probe into this approach by reinforcing positive attitudes in Nursing students. These findings show the need to seek strategies through specific educational interventions and policies. Engagement should be upheld throughout the degree and once they enter the job market to ensure the well-being during academic and future work life, a high-quality nursing care and patient safety.
Collapse
Affiliation(s)
- Raquel Rodríguez-González
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alba-Elena Martínez-Santos
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain; Dermatology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Noelia Vicho De La Fuente
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Nursing Department, Galician Health Service, Galicia, Spain
| | - María-Elena López-Pérez
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | |
Collapse
|
5
|
Tschannen D, Alexander C, Bidisha G, Zellefrow C, Milner KA. Original Research: Exploring Frontline Nurses' Self-Perceived Levels of QI Engagement and QI Competence. Am J Nurs 2023; 123:22-33. [PMID: 37498035 DOI: 10.1097/01.naj.0000947456.74501.f6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND PURPOSE Nurse engagement in quality improvement (QI) is critical in the delivery of safe high-quality care, yet few studies have evaluated frontline nurses in this area. The purpose of this study was to identify and compare levels of self-reported QI engagement and QI competence among frontline nurses and nurse leaders. METHODS This study used a cross-sectional descriptive design. A convenience sample of frontline nurses (bedside RNs and advanced practice nurses) and nurse leaders from acute and ambulatory care sites completed the Nursing Quality Improvement in Practice (NQuIP) tool, which measures engagement and competence (knowledge, skills, and attitudes) in QI. RESULTS Data from 6,351 surveys completed by frontline nurses and nurse leaders representing 66 sites nationwide were analyzed. Only 52.5% of all respondents reported participating in QI. Knowledge scores were relatively high, while skills scores-especially those related to using QI tools-were low. Overall attitudes toward QI were positive. Nurse leaders scored significantly higher in engagement and competence than the frontline nurses they supervise. CONCLUSIONS The study findings indicate that nurse engagement in QI is limited. Although nurses' knowledge levels appear to be high, their limited competency in QI-related skills may contribute to low QI engagement. Leaders must make efforts to increase nurse engagement in order to attain high-quality outcomes. Using the NQuIP tool will allow leaders to evaluate nurses' self-perceived QI competence and engagement, which will aid in identifying target areas and developing effective strategies for improvement.
Collapse
Affiliation(s)
- Dana Tschannen
- Dana Tschannen is a clinical professor at the University of Michigan School of Nursing in Ann Arbor, where Bidisha Ghosh is the lead statistician in the School of Nursing's Applied Biostatistics Laboratory. Catherine Alexander is a chief nurse scientist at the Veterans Affairs (VA) Connecticut Healthcare System, New Haven; at the time of this study, she was a quality management performance improvement analyst at the San Francisco VA Medical Center. Cindy Zellefrow is director of the Academic Core at the Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, The Ohio State University, Columbus. Kerry A. Milner is a professor at Sacred Heart University's Susan L. Davis & Richard B. Henley College of Nursing, Fairfield, CT. Contact author: Dana Tschannen, . The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | |
Collapse
|
6
|
Prochnow L, DiClemente L, Riley P, Tschannen D. Examining QI Knowledge Among Frontline Nurses and Nurse Leaders. J Nurs Care Qual 2023; 38:152-157. [PMID: 36214701 DOI: 10.1097/ncq.0000000000000672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Frontline nurses deliver direct patient care and by participating in quality improvement (QI) can have an impact on health care quality and safety. Unfortunately, nurses are not participating in QI, which may be due to a lack of QI knowledge. PURPOSE The purpose of this study was to evaluate nurses QI knowledge utilizing the revised Quality Improvement Knowledge Application Tool (QIKAT-R), with newly created nursing scenarios, among frontline nurses and nurse leaders. METHODS Using a cross-sectional design, this study evaluated nurses QI knowledge utilizing the QIKAT-R. RESULTS Overall, QI knowledge among nurses was low. The frontline nurses (n = 44) scored higher than nurse leaders (n = 11) on overall QI knowledge scores, although not significant. Frontline nurses scored higher in QI knowledge related to aim and measure, whereas nurse leaders scored higher in change. CONCLUSIONS Understanding frontline nurses QI knowledge, such as with the QIKAT-R with newly created nursing scenarios, can assist with creating targeted strategies for improving overall engagement in QI.
Collapse
Affiliation(s)
- Laura Prochnow
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor
| | | | | | | |
Collapse
|
7
|
Yang L, Zhang S, Leng J, Fan Z, Luo Y. Development of the Nurse Occupational Stigma Scale. Psychol Res Behav Manag 2022; 15:1627-1636. [PMID: 35813037 PMCID: PMC9259052 DOI: 10.2147/prbm.s362709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/28/2022] [Indexed: 01/17/2023] Open
Abstract
Introduction Objective Methods Results Conclusion
Collapse
Affiliation(s)
- Lu Yang
- Department of Nursing, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People’s Republic of China
| | - Shuangxin Zhang
- Department of Nursing, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People’s Republic of China
| | - Jiaqi Leng
- Department of Education, Jilin International Studies University, Changchun City, Jilin Province, People’s Republic of China
| | - Zhiguang Fan
- Department of Education, Jilin International Studies University, Changchun City, Jilin Province, People’s Republic of China
- Correspondence: Zhiguang Fan, Department of Education, Jilin International Studies University, Jingyue Street 3658, Changchun City, Jilin Province, People’s Republic of China, Tel +86 1 594-831-4623, Fax +86 431-84924101, Email
| | - Yi Luo
- Department of Nursing, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People’s Republic of China
| |
Collapse
|
8
|
Blok AC, Alexander CC, Tschannen D, Milner KA. Quality improvement engagement: Barriers and facilitators. Nurs Manag (Harrow) 2022; 53:16-24. [PMID: 35225833 DOI: 10.1097/01.numa.0000821708.46746.6f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A comparison of frontline nurses, advanced practice nurses, and nurse leaders.
Collapse
Affiliation(s)
- Amanda C Blok
- Amanda C. Blok is a research health scientist with the VA Center for Clinical Management Research at the VA Ann Arbor Healthcare System and a research assistant professor in the Department of Systems, Populations, and Leadership at the University of Michigan School of Nursing in Ann Arbor, Mich. Catherine C. Alexander is a performance improvement analyst at the San Francisco (Calif.) VA Medical Center. Dana Tschannen is a clinical professor and the associate dean for undergraduate studies at the University of Michigan School of Nursing in Ann Arbor, Mich. Kerry A. Milner is a professor at Sacred Heart University Davis & Henley College of Nursing in Fairfield, Conn
| | | | | | | |
Collapse
|
9
|
Alexander C, Tschannen D, Argetsinger D, Hakim H, Milner KA. Qualitative Study on Barriers and Facilitators of Quality Improvement Engagement by Frontline Nurses and Leaders. J Nurs Manag 2021; 30:694-701. [PMID: 34969172 DOI: 10.1111/jonm.13537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/28/2022]
Abstract
AIM To understand the facilitators and barriers of quality improvement (QI) from the perspective of nurses and leaders at the frontline. BACKGROUND Nurse engagement in QI has been associated with quality care and improved patient outcomes, yet nurse reported participation is low. METHODS A descriptive qualitative design and purposive sampling was used to examine barriers and facilitators of nurse engagement. RESULTS Facilitators 1) A leader's influence on a QI culture. Sub themes: creating buy-in, support of a just culture and working in partnership with nurses. Barriers 1) Barriers in organizational culture for nurses to lead QI. Sub themes: hierarchy, absence of a just culture, nurses' role not valued, lack of accountability for QI in nursing role, and resistance to change 2) Barriers in organizational structure for nurses to lead QI. Sub themes: manager disengagement, time pressure, lack of access to timely data, lack of QI knowledge, siloed departments, and lack of QI experts. CONCLUSION Barriers to QI engagement prevent nurses from fully engaging in QI. Creating a just culture and building the infrastructure to support nurse engagement is critical for success. IMPLICATIONS FOR NURSING MANAGEMENT Specific facilitators and barriers were identified that nurse leaders can assess in their practice setting and use relevant strategies to support engagement in QI.
Collapse
Affiliation(s)
| | - Dana Tschannen
- University of Michigan, School of Nursing, 400 N, Ann Arbor, MI, US
| | - Debora Argetsinger
- Metro Health-University of Michigan Health, 5900 Byron Center Ave SW, Wyoming, MI, US
| | | | - Kerry A Milner
- Sacred Heart University, Davis & Henley College of Nursing, Fairfield
| |
Collapse
|