Quality improvement: Online resources to support nursing education and practice.

BACKGROUND: Quality improvement (QI) competence is included in the American Association of Colleges of Nursing Essentials for pre-licensure and graduate degrees and is invaluable to nurses at all levels of professional practice. Among barriers to integration of QI competency is insufficient QI knowledge and skills among faculty and practicing nurses. Many nurses completed their nursing education before the introduction of the QI competencies in nursing programs, and it is understandable if they lack QI knowledge, skills, and attitudes. PURPOSE: The purpose of this review is to provide information about QI online resources to nursing faculty, nurse leaders, and nurses in clinical practice with educational and training tools and opportunities to broaden their QI competence. METHODS: The authors completed a comprehensive review of online resources for learning and/or teaching QI in health care and explored the websites of eight organizations. RESULTS: Within eight selected websites, the authors chose over 20 online self-study resources to learn and/or teach QI in health care with content for beginner, intermediate, and advanced learners. CONCLUSION: The QI online resources are easily accessible and can enable learning and engagement in QI of nursing faculty, students, and practicing nurses with no or limited exposure to the discipline.

Using Multisite Process Mapping to Aid Care Improvement: An Examination of Inpatient Suicide-Screening Procedures.

Although most suicides occur outside of medical settings, a critical and often overlooked subgroup of patients attempt and complete suicide within general medical and inpatient units. The purpose of this quality improvement initiative was to perform a baseline assessment of the current practices for suicide prevention within medical inpatient units across eight Veterans Affairs medical centers throughout the nation, as part of the VA Quality Scholars (VAQS) fellowship training program. In conjunction with the VAQS national curriculum, the authors and their colleagues used multisite process mapping and developed a heuristic process to identify best practices and improvement recommendations with the hopes of advancing knowledge related to a key organizational priority-suicide prevention. Findings demonstrate a multitude of benefits arising from this process, both in relation to system-level policy change as well as site-based clinical care. This interprofessional and multisite approach provided an avenue for process literacy and consensus building, resulting in the identification of strengths including the improvement of prevention efforts and accessibility of supportive resources, the discovery of opportunities for improvement related to risk detection and response and the patient centeredness of current prevention efforts, and the provision of solutions that aim to achieve sustained change across a complex health system.

Implementing a patient-centered walking program for residents in long-term care: A quality improvement project.

BACKGROUND AND PURPOSE: This quality improvement (QI) project was designed to increase walking activity for eligible residents in long-term care (LTC). Walking programs have positive benefits; however, they are underused in LTC. METHODS: The Model for Improvement and Plan-Do-Study-Act cycles were used to implement the key components including building a guiding coalition, environment and policy assessment, development of a patient-centered walking program protocol, staff education, mobility huddle to motivate and mentor staff, and ongoing evaluation and feedback. RESULTS: Of the 78 residents screened for walking activity, 13 (17%) were eligible. Data were collected weekly. After 20 weeks, 69% (n = 9) of the enrolled residents were still in the program. The majority of residents were provided walking activity between 60% and 90% of the time. None of the residents experienced a fall during the activity. Average adherence to documenting the activity was 79%. CONCLUSIONS: The QI project provided the implementation and evaluation of a consistent walking program in a LTC setting. IMPLICATIONS FOR PRACTICE: The project findings may assist nurse practitioners in implementing QI initiatives in LTC to increase walking activity of eligible residents and aid in evaluating those programs. However, leadership commitment and ongoing support are essential to sustain the effectiveness of a program.