Optimizing Quality Improvement Methods in Practice: A Case Study Approach.

BACKGROUND: Quality improvement (QI) initiatives help ensure patients are receiving high-quality care. Iterative Plan-Do-Study-Act (PDSA) cycles are used to test change. Data are evaluated over time, and tests of change can be modified or discarded as needed. PROBLEM: Health care QI teams lack the flexibility to conduct PDSA cycles, often conducting pre/post quasi-experimental research studies instead. APPROACH: This article reviews a case study of a "personal improvement" initiative as an example of QI methods and data evaluation for an individual trying to lose weight. The purpose of this article is to provide guidance on best practices for conducting QI initiatives; common pitfalls that clinicians may face when leading their own QI initiatives are identified and recommendations to overcome these challenges are discussed. CONCLUSIONS: Concepts from this case study, along with supplemental resources provided, can help clinicians optimize QI methodologies in the health care setting.

Nurse editors' roles and practices.

PURPOSE: While nurse editors carry great responsibility for the scientific literature in the nursing profession, little has been published about this unique role. The purpose of this study was to examine contemporary nurse editors' roles and practices. DESIGN: In early 2019, a sample of 129 nurse editors participated in a cross-sectional study using survey methods. METHODS: The online survey was based on an instrument used in a prior study and included 43 primarily multiple-choice questions. Findings were analyzed using descriptive statistics. FINDINGS: Beyond the expected roles of journal management, editorial decision making, leadership for the profession, and specific journal focus, some aspects of the nurse editor role have remained unchanged. The role continues to be learned mostly on the job and nurse editors still find satisfaction in helping other nurses publish and disseminate their work. Nurse editors are older and better educated. They also are receiving more manuscripts submitted to their journals and perceive this role as hard work but worth it. This is also the first study to report on the role of other levels of editors. CONCLUSION: This study provides a description of the current roles and practices of nurse editors. Nurse editors can bring more attention to the role and encourage more nurses to consider this role as an attainable and a satisfying one. CLINICAL RELEVANCE: Being a nurse editor is a leadership role and one that many nurses may not consider as a career goal. Nurse editors can increase the visibility of this role and engage, encourage, and support nurses who are interested in this role.

Integrating Maternal Depression Screening Into an Early Intervention Program: An Implementation Evaluation.

BACKGROUND: In all 50 states, early intervention (EI) services to improve long-term child cognitive and academic outcomes are provided to infants and toddlers with suspected or diagnosed developmental delays. When mothers of EI-enrolled children experience depressive symptoms, uptake of EI services can be compromised. AIMS: The purpose of the article is to present a depressive symptom screening intervention for mothers consisting of toolkit development for EI staff and families, symptom screening for mothers and follow-up protocol. To formally evaluate the implementation of the intervention, our research team followed the consolidated framework for implementation research (CFIR). METHODS: Participants were 12 EI service coordinators across two offices. Focus groups and individual interviews were used to develop the toolkit and education module. Through the five CFIR domains, we evaluated the implemented intervention in order to allow other teams to learn from our experiences. RESULTS: Our team successfully partnered with SCs to develop the intended deliverables. Still, the SCs found it challenging to conduct the screenings and reported mixed success. CONCLUSIONS: Preparation of EI SCs to integrate mental health screenings into their existing skillsets requires a high level of support from the research team, resulting in a rich understanding of the barriers-and potential rewards-for staff and families.

Publishing in Predatory Journals: Guidelines for Nursing Faculty in Promotion and Tenure Policies.

PURPOSE: The purpose of this study was to assess the extent to which academic promotion and tenure (APT) criteria and guidelines in schools of nursing recognize predatory publishing. This assessment included an analysis of APT documents looking specifically for guidance about predatory publications by faculty in schools of nursing. DESIGN: This study used a cross-sectional, descriptive design and was conducted in 2020. METHODS: A mixed methods approach was used to collect data from two sources. Data were extracted from APT documents for 92 research-intensive universities found online and specifically focused on documents for universities and for schools of nursing in the United States. Interviews were conducted with a subsample of academic administrators (n = 10) from selected schools. FINDINGS: The majority (57%; n = 50) of APT documents reviewed addressed quality of the journals in which faculty publish. However, very nonspecific terms, such as "high quality" or "peer reviewed" were used. None of the documents reviewed (n = 88) included any reference to predatory journals. Deans who were interviewed validated the analysis of the APT documents. While most deans reported faculty were aware of predatory journals and the risks of publishing in them, formal guidelines for consequences for publishing in predatory journals were not developed or available. CONCLUSION: This study examined how schools of nursing in research-intensive universities address the issue of predatory journals. APT criteria do not provide guidance to faculty and promotion and tenure committees about issues related to predatory publications as low-quality publication outlets. Recommendations for APT committees, mentors, and faculty are provided. CLINICAL RELEVANCE: Clinicians rely on researchers, many of whom are faculty, to publish rigorous studies that produce evidence they can translate into practice. One measure of the quality of a study's findings is where the paper is published and reflects the level of peer review it has been through. Faculty who publish in predatory journals may not have had their work reviewed by experts; evidence produced may or may not be adequate for translation to guide nursing practice.

Perceptions of Body Size in Mothers and Their Young Children in the Galapagos Islands.

Introduction Little specific information has been published about the health of people who live in the Galapagos Islands. As part of determining the status of the nutrition transition that may be occurring in the islands mothers of young children in the Galapagos perceptions of their child's body size and therefore health status was evaluated along with actual body size. Methods This paper presents data collected as part of a pilot study that used a mixed methods approach to identify and describe health and nutrition issues for mother-child pairs on Isla Isabela in Galapagos, Ecuador. It includes participant anthropometric assessment and self-perception of body size using silhouettes for themselves and one of their children along with open-ended questions to elicit further understanding of body size perceptions. Twenty mothers of children greater than 6 months of age but less than 6 years of age were interviewed. Results The women preferred a smaller body size for themselves but a larger body size for their children. Findings of different body size combinations between mothers and children in the same household demonstrated that the island is undergoing or may be post the nutrition transition. Discussion This dual burden of body weights (especially overweight or obese mothers) in the same household with underweight, normal and overweight or obese children and the potential nutrition related chronic disease burden in the future will require more educational resources and innovative health services than are currently available for the people of the Galapagos.

NP Role and Patient Outcomes Are Supported by High-Level Evidence. Comment on Almutairi et al. Nurse Practitioner: Is It Time to Have a Role in Saudi Arabia? Nurs. Rep. 2020, 10, 41-47.

This is a letter to the editor in response to the article titled "Nurse Practitioner: Is it Time to Have a Role in Saudi Arabia?" Clarifications on the nurse practitioner role definition and description, educational preparation, and quality and value of care are made and supported with authoritative, high-quality evidence.

Guideline-based educational intervention to decrease the risk for readmission of newborns with severe hyperbilirubinemia.

INTRODUCTION: The purpose of this study was to determine if educational intervention with medical providers in combination with a management tool to facilitate clinical guideline usage would (a) increase quality of care, (b) increase compliance with published guidelines, and (c) decrease hospital readmissions as a result of hyperbilirubinemia in the first week of life. METHOD: A quality improvement initiative was undertaken with a preintervention/postintervention design. INTERVENTION: An educational intervention was offered to persons who provide medical care to newborns. The charts of newborns were reviewed before and after the intervention in three samples: a care quality sample (N = 244), a compliance sample (N = 240), and a readmission sample. RESULTS: In the quality care sample, documentation of three quality care indicators improved significantly and one worsened significantly. In the compliance sample, the percentage of infants who were given appropriate follow-up appointments in primary care based on their hyperbilirubinemia risk at discharge improved (p = .03), and the readmission rate of newborns within the first week of life as a result of hyperbilirubinemia decreased by 50%. DISCUSSION: An educational intervention with a clinical tool may help change provider practice. Longer follow-up is needed to determine if the impact is sustainable.