Nursing Quality
According to the American Nurses Association [ANA] (n.d.), there are different approaches to ensuring the high quality of care; measuring nursing-specific criteria is among them. ANA (n.d.) recommends the National Database of Nursing Quality Indicators® (NDNQI) for that purpose. According to ANA (n.d.) and Press Ganey Associates (2019), NDNQI is a research program that collects and produces information associated with nursing-related care outcomes. The data is then used to introduce new nursing quality indicators and evaluate existing ones. The indicators that comprise the database today incorporate hospital-acquired infections (Lockhart, 2018), which makes NDNQI relevant for a project aimed at reducing catheter-associated urinary tract infections (CAUTI). ANA (n.d.) and Press Ganey Associates (2019) describe the database as one of their primary solutions to promoting nursing quality, and this perspective can be supported by some recent peer-reviewed studies.
Garrard, Boyle, Simon, Dunton, and Gajewski (2016) focused on NDNQI’s falls with injury indicators to determine whether it provided correct, accurate, and consistent results. Over 400 sites sent their data for this project, and the analysis demonstrated NDNQI’s validity and reliability were sufficiently high. Staggs, Davidson, Dunton, and Crosser (2015) considered the database from a different perspective; they presented a report of the challenges that NDNQI specialists encountered when defining and revising its fall indicators. The problems included the need for a balance between obtaining detailed data and managing the timeframe and costs, but the authors highlighted the significance of acquiring highly reliable data for indicator development. This article provides actionable advice for future NDNQI indicator development, but it also details the rigorous process meant for introducing such indicators. As a result, both studies demonstrate the validity and value of the program.
NDNQI is voluntary, but as demonstrated by ANA (n.d.), measurement is a vital aspect of quality improvement because it provides opportunities for benchmarking, setting goals, and tracking progress. To follow ANA’s (n.d.) advice, a nurse, especially a nurse leader who is a Doctor of Nursing, an advocate for the implementation of NDNQI. The first step would be to gather enough data about the program and collect ample evidence of its validity, which would be necessary to argue for its introduction; the above-presented articles are an example of reliable sources. For the CAUTI project, NDNQI could provide some information about CAUTIs and their rates, which could be applied to benchmarking the results. In general, as shown by the literature and expert statements by ANA (n.d.), NDNQI is a useful tool for a nurse.
Work with Professionals
The CAUTI project involved a lot of interprofessional and professional collaboration. Specifically, the nurses and nursing assistants required training, and the project needed coordination, which, among other things, involved obtaining permissions and approving its schedule. The project was recognized as a quality improvement effort, which resulted in it being accepted as a beneficial opportunity. Since the participation is voluntary, it is not likely to cause any negative outcomes for the professional collaboration between the participants, those who do not participate, or the researcher. Still, as the work continues, more interactions between professionals will be required to ensure its smooth implementation. Collaboration demands diverse strategies that can minimize conflicts and other challenges, and this paper will present three articles to guide the process.
Challenges that are common for interactions between professionals should be mentioned. Wittenberg, Goldsmith, and Neiman (2015) reported the experiences of 193 palliative nurses with their teams. The participants discussed the problem of conflict and difficulties in establishing team collaboration and communication. In turn, according to the review of 28 sources performed by Foronda, MacWilliams, and McArthur (2016), ineffective communication may be connected to disparate training, philosophies, and communication styles. Similarly, Senot, Chandrasekaran, and Ward (2016), who used 49 interviews for their case studies of interprofessional collaboration in the US, found that differences in the professionals’ perspectives and experiences could be a challenge. Also, the findings of Foronda et al. (2016) and Senot et al. (2016) supported the idea that hierarchical structures might not be helpful in collaboration, and inefficient organization could only hinder it. To summarize, the fact that collaboration is important but difficult to achieve is apparent from the literature.
When considering solutions, Wittenberg et al. (2015) recommended team building and communication skill development. However, when considering more specific strategies, Foronda et al. (2016) discussed the training approaches that would expand the perspectives of professionals. Also, Senot et al. (2016) reported that their respondents found nurse- and other professional-led collaboration helpful in mitigating issues that depended on the introduction of the perspectives of nurses or other professionals. It can be indeed a useful strategy to recognize the viewpoint of the other individual or group involved in collaboration; acting with the knowledge of the differences in others’ opinions might assist in avoiding conflicts or miscommunication and strengthening the team. This approach, as well as interpersonal skills and general knowledge of team dynamics and interprofessional challenges, should help in managing the collaboration for the rest of the project. If it is handled well, the outcomes may include improved communication between the nurses and nursing assistants who are involved in the effort.
References
American Nurses Association. (n.d.). Nursing quality. Web.
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40.
Garrard, L., Boyle, D., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal of Nursing Research, 38(1), 111-128.
Lockhart, L. (2018). Measuring nursing’s impact. Nursing Made Incredibly Easy, 16(2), 55.
Press Ganey Associates. (2019). Capture nursing-specific measures. Web.
Senot, C., Chandrasekaran, A., & Ward, P. (2016). Collaboration between service professionals during the delivery of health care: Evidence from a multiple-case study in U.S. hospitals. Journal of Operations Management, 42-43(1), 62-79.
Staggs, V., Davidson, J., Dunton, N., & Crosser, B. (2015). Challenges in defining and categorizing falls on diverse unit types. Journal of Nursing Care Quality, 30(2), 106-112.
Wittenberg, E., Goldsmith, J., & Neiman, T. (2015). Nurse-perceived communication challenges and roles on interprofessional care teams. Journal of Hospice & Palliative Nursing, 17(3), 257-262.