The Role of Nurses in Hospital Quality Improvement

Abstract

Demand for Hospital Quality Improvement

The demand for quality improvement in hospitals is ever increasing due to federal government mandates, as well as local requirements, accreditation or regulatory boards, hospital organizations, medical societies, non-profit organizations (NGOs) and and health insurance plans. Core qualities reported may vary in terms of target medical concern or hospital department, but in most cases, employee and patient feedback is included in the measurement.

The Joint Commission aims to standardize measurements used to check hospital quality. Primary factors relate to the hospital as a whole, medical staff (nurses in particular) and patients.

Since the measurements used vary, attempts to standardize the process have been made. While it’s not final, the Joint Commission’s efforts have been the most conclusive. Their measures include the following:

• Failure to rescue
• Falls as well as falls with injury
• Prevalence of pressure ulcer as well as restraint (vest and limb)
• Intensive care unit (ICU) concerns such as urinary catheter-associated urinary tract infections, central line catheter-associated bloodstream infections and ventilator-associated pneumonia
• Smoking related counseling for acute myocardial infarction, heart failure and pneumonia
• Skill mix
• Scheduled hours daily versus number of patients assisted
• Practice Environment Scale of the Nursing Work Index (PES-NWI)
• Voluntary turnover