Quality and Safety Education for Nurses: Core Competencies for Nursing Leadership and Care Management

Cover
Title
Copyright
Dedication
Contents
Contributors
Foreword
Preface
Why This Book?
Chapter Features
Highlights of the Text
Instructor Resources
References
Acknowledgments
Unit I: Role of the Nurse in Healthcare
Chapter 1: Patient Safety and Quality of Care as Measures of Nursing Competence
Introduction
Quality of Care and Patient Safety
Drivers for Quality and Safety
National Organizations Impacting Healthcare Improvement
Global Advances in Quality and Safety
The Patient Safety Movement to Improve Quality and Safety
The Cost of Achieving Quality and Safety
Recognizing Healthcare Excellence
The Beginning of Quality and Safety Education for Nurses
Integration of the Quality and Safety Education Competencies Into Nursing Education
Integration of the Knowledge, Skills, and Attitudes Into Nursing Curricula
Applying the Quality and Safety Education Competencies in Practice
Patient-Centered Care
Teamwork and Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics
Nurses’ Role in Quality and Safety as Direct Care Providers and Leaders
Recognizing Nursing Excellence
The Role of Nurse Leaders in Ensuring Quality and Safety
Accreditation and Evaluation of Quality and Safety Education for Nurses Competencies
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring The Web
References
Chapter 2: Nurses as Leaders and Managers for Safe, High-Quality Patient Care
Introduction
Value of Enhancing Leadership Skills of Nurses at the Bedside
Apply Leadership and Management Theory to Transform Nursing Practice to Improve Care
Roles and Education of Nurses Leading and Managing Quality Care
Motivating Nurses on the Frontline of Patient Care to Lead and Manage Quality Improvement
Organizational Structures in Hospital Healthcare Settings
Leadership and Management Influence an Organization’s Culture
Events to Mark the Advancement of Nursing as a Profession
Professional Development and Education is a Life-Long Endeavor
Benefits of Membership in Nursing Organizations
Learning Systems and Innovation for Safe, High-Quality Patient Care
Leadership and Management Skills Transfer to Crisis Management
Key Concepts
End-Of-Chapter Resources
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 3: Systems Thinking
Introduction
Define the Theoretical Principles of a System
Systems Theory in Other Fields
Define Systems Thinking
Looking at the Big Picture
Recognizing Patterns
Reflection
Willingness to Change
Applying Systems Thinking to Nursing Practice
Identify the Origins of Systems Thinking in Healthcare
Historical Development of Systems Thinking in Healhcare
Organizations That Foster Systems Thinking in Healthcare
Discuss the Impact of Systems Thinking on Quality and Safety Processes
Example 1: Medication Adminstration
Example 2: Hospital-Acquired Infections
Example 3: Length of Stay
Examine Ways to Foster Systems Thinking in Practice
Self-Assessment
Strategies to Learn How to Become a Systems Thinker
Concept Mapping
The Iceberg Model Challenge
Discuss the Role of Leadership as a Component for Systems Thinking
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 4: Legal and Ethical Aspects of Nursing Quality and Safety
Introduction
Three Branches of the U.S. Federal Government
Administrative Agencies
The Role of the Law in Shaping Nursing Practice
Criminal Law Versus Civil Law
Statutory Law Versus Common Law
Nurse Practice Acts
The Four Elements of Negligence or Malpractice
Duty of Care Owed to Patient
A Breach in the Duty of Care
Injury Proximately Caused by the Breach in Duty of Care
Damages
Independent Responsibility of Nurses to Deliver Quality Patient Care
Responsibility for Prevention of Hospital-Acquired Infections
Health Insurance Portability and Accountability Act of 1996
Regulation of Patient Information
Permitted Uses of Patient Information by Health Insurance Portability and Accountability Act
Health Insurance Portability and Accountability Act Authorized Disclosure of Patient Information
Health Insurance Portability and Accountability Act Penalties
Medicare Home Health Certification Requirements
Federal Anti-Kickback Statute
Civil Monetary Penalties Law
Exclusions From Medicare, Medicaid, or Other Federal Healthcare Programs
Whistleblower Claims
International Council of Nurses Code of Ethics, The American Nurses Association Code of Ethics, and Underlying Principles
Steps of the Ethical Decision-Making Process
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Reading
Chapter 5: Delegation and Setting Priorities for Safe, High-Quality Patient Care
Introduction
Delegation
State Nurse Practice Acts
Responsibility
Delegated Responsibility
Assignment
Accountability
Authority
Supervision
National Guidelines for Nursing Delegation
National Council of State Boards of Nursing Five Rights of Delegation
Chain of Command
American Nurses Association and National Council of State Boards of Nursing National Guidelines for Nursing Delegation
Scope of Nursing Practice Decision-Making Framework
Communication Factors Influencing the Delegation Process
Delegation in Community Settings
Assignment Sheets and Handoff Report
Handoff Reports
Application of the Five Rights of Delegation
Right Task and Right Circumstances
Right Tasks Assigned to the Right Person Under the Right Circumstances Using the Right Direction and Communication
The Right Supervision and Evaluation
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Unit II: Quality and Safety Competencies
Chapter 6: Person-Centered Care
Introduction
A Brief History of Person-Centered Care
Characteristics of Person-Centered Care
Organizational Structures of Patient-Centered Care
Role of Customs in Patient-Centered Care
Cultural Competence
Advocacy
Communication and Patient-Centered Care
Empathetic Communication
Influence of Culture and Language on Patient-Centered Care Communication
Patients and Interprofessional Communication
Psychosocial Factors Associated With the Role of the Patient
Strategies to Support Patient-Centered Care Practice
Alleviating Barriers to Health Literacy
Shared Decision-Making
Patient Decision AIDS
Person-Centered Care and the Social Determinants of Health
Strategies to Enhance Team-Based Approach to Social Determinants of Health
Discharge Planning and Person-Centered Care Continuity
Patient Navigators
Innovations to Support Person-Centered Care
Patient Journals
Patient-Driven Research
Online E-Patient Communities
Legislation That Supports Patient-Centered Care Practices
Patient Protection and Affordable Care Act
Patient-Centered Medical Home
Patient-Centered Primary Care Collaborative
Medicaid Health Homes
Person-Centered Care Measures to Monitor Quality Healthcare
Strategy for Quality Improvement in Healthcare
Patient Satisfaction
Patient Satisfaction Surveys
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Reading
Chapter 7: Interprofessional Teamwork and Collaboration
Introduction
What is an Interprofessional Team?
Role and Core Competencies of Interprofessional Teams
Nursing’s Evolving Role on Interprofessional Teams
Advancing Healthcare Through Improved Education
Strategies for Maximizing Effective Interprofessional Teams
Rapid Response Teams
Teams Coordinating Care to Reduce Risks
Characteristics of Effective Interprofessional Healthcare Teams
Accountability and Stages of Team Development
Delegation
Crew Resource Management
Teamstepps
Situation, Background, Assessment, and Recommendation
Additional Techniques for Effective Communication Within Interprofessional Teams
Use of Informatics for Effective Problem-Solving
Auditing Patient Care and Outcomes
Constructive Feedback and Reflection’s Impact on Improvement
Reflection
Developing Clinical Judgment to Think Like a Nurse
Strategies to Include the Patient as Partner
Overcoming Barriers to Effective Communication and Teamwork
Strategies for Communication in Difficult Situations
Managing Conflict
Horizontal Violence
Communicating With Preceptors
Cognitive Rehearsal
Communicating With Hospital and Nursing Leadership
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 8: Informatics
Introduction
Nursing Informatics Defined
Metastructure of Nursing Informatics
Electronic Medical Records and Electronic Health Records
Historical Basis for Electronic Health Records
Developing Electronic Health Records
Native, Accurate, Reliable, and Timely Data
Easy to Use
Intuitive Displays
Navigation
Evidence at the Point of Care
Enhance Workflow
Limit Inefficiencies
Exchange of Information
Important Legislation Impacting Patient Safety
Health Insurance Portability and Accountability Act
Information Privacy
Security
The Health Information Technology for Economic and Clinical Health Act
Meaningful Use
Standards for Interoperability
Health-Related Websites
Technology Initiatives for Safe Patient Care
Data Capture to Improve Quality
Clinical Decision Support Systems
E-Prescribing
Patient Portals
Technologies and Information Systems in Hospitals
Communication Technologies
Computerized Physician Order Entry
Bar-Code Medication Administration
Radio Frequency Identification
Technology in Direct Patient Care
Smart Healthcare Devices
Alarm Fatigue
Telehealth
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Quality and Safety Education for Nurses Activities
Review Activities
Exploring the Web
References
Suggested Reading
Chapter 9: Evidence-Based Nursing Practice
Introduction
Definition of Evidence-Based Practice
Best Available Evidence
Basic Literature Search Strategies
Crafting a Searchable Question
Deciding Where to Search
Electronic Databases for Searching the Literature
Point of Care Databases
Select Clinical Practice Guidelines
Literature Searching With Keywords and Subject Headings
Keyword Searching
Subject Headings/MeSH Subject Headings
Search Techniques
Search Limits
Truncation and Wildcards
Citation Chasing and Hand Searching
Search Structure
Evidence Types
Evidence Appraisal
Tools to Appraise Evidence From the Literature
Appraisal of Guidelines for Research and Evaluation Instrument
The Critical Appraisal Skills Program
Resources for Lifelong Learning
Clinical Expertise
Patient Preferences
Nurses, Role in Evidence-Based Practice
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 10: Patient Safety
Introduction
High-Quality Structures and Processes to Achieve High-Quality Outcomes and Safety
Financial Consequences
A Just Culture of Safety
Medication Safety
Leadership
Measurement
Risk Identification and Reduction
High Reliability
Teamwork
The Role of Utilization Management in Supporting a Just Culture of Safety
OVERUSE, UNDERUSE, AND MISUSE OF HEALTHCARE SERVICES
A Person Approach Versus a System Approach to Patient Care Safety
Strategies That Reduce Variation and Standardize Safe Patient Care Delivery
Organizations That Sustain and Spread Healthcare Safety
Safety Initiatives in Healthcare
Avoidance of Workplace Violence
Healthcare Ranking and Information Sources
Disparity in Safety Outcomes
Safe Nurse Staffing
Nurses With Impairing Conditions
Hand Hygiene
Suicide Prevention
Environmental Safety
Safety for Healthcare Staff
Safety Risks for Nurses
Safe Patient Handling
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 11: Quality Improvement Essentials
Introduction
Defining Quality Improvement
History and Evolution of Quality Improvement in Healthcare
Quality Improvement in Nursing
Is Quality Improvement Evidence-Based Practice or Research?
Quality Improvement Models and Methodologies
Donabedian’s Model
Lean
Six Sigma and Define, Meausre, Analyze, Improve, and Control
Approaches to Quality Improvement Problems
Retroactive Approach: Root Cause Analysis
The Role of the Nurse in Quality Improvement
Auditing
Leadership Support
Overcoming Quality Improvement Barriers
End-Of-Chapter Resources
Key Concepts
Key Terms
Review Questions
Review Activities
References
Suggested Readings
Chapter 12: Quality Improvement Tools
Introduction
What are Data
SOURCES OF OBJECTIVE DATA FOR QUALITY IMPROVEMENT
Aggregate Data
Operational Definitions
DATA COLLECTION
Descriptive Statistics
Data Display
Histograms
Scatter Plot Diagrams
PARETO CHART
Statistical Process Control)
The Run Chart
The Shewhart Control Chart
Stratification
Other Quality Improvement Team Tools
Gantt Chart
Flow Map
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Unit III: Application for Practice
Chapter 13: Implementation Science
Introduction
Innovation, Improvement, and Implementation Science Approaches
Major Implementation Frameworks
Consolidated Framework For Implementation Research
Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)
Dynamic Sustainability Framework
Hybrid Research Designs
Applying Quality and Safety Education for Nurses Competencies to Implementation Science
Implementation Science and Bedside Clinical Care, Patient Education, Professional Development, and Nursing Research
Implementation Science in Nursing Practice
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 14: Quality Improvement and Project Management
Introduction
Project Management Techniques Improve the Delivery of Quality Improvement Projects
Nurse’s Role as an Interprofessional Team Member
Systematic Phases of Project Management
Project Management Phase 1: Initiating
Project Management Phase 2: Planning
Project Management Phase 3: Executing
Lean Method for Project Management
Six Sigma Method for Project Management
Five-Step Method for Project Management
Project Management Phase 4: Monitoring and Controlling
Project Management Phase 5: Closing
Application of Systematic Steps of Project Management
Define
Measure
Analyze
Improve
Control
Leadership and Management Skill for Project Management
Benefits and Limitations for Project Management
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 15: Population Health and the Role of Quality and Safety
Introduction
Evolution of Population Health
Population Health and Nursing Practice
Overlapping Concepts Between Population Health and Public Health
Three Levels of Prevention
Population-Focused Nursing Competencies and Quality and Safety Education for Nurses Competencies
Population Health and the Interprofessional Team
Emerging Nursing Roles In Population Health
Quality Improvement and Population Health
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Chapter 16: Professional Role Development in Patient Safety and Quality: Transitioning to Practice
Introduction
Benner’s Professional Development Model
The Role of Nursing Orientation in Transition to Practice
Transition to Practice Programs as Nurse Residencies
The Role of Preceptors and Mentors
Role and Characteristics of Preceptors
Role and Characteristics of Mentors
Regulatory Agencies and National Initiatives for Quality and Safety
The Joint Commission
Institute for Healthcare Improvement
Nursing-Sensitive Indicators and the Nurse’s Role
Quality and Safety-Framed Nursing Orientation Programs
One Hospital’s Story of a Quality and Safety Education for Nurses-Framed Nursing Orientation Program
Strategies to Foster Nursing Professional Development
Pathways for Transitioning to Leadership Roles After Orientation
End-Of-Chapter Resources
Key Concepts
Critical Discussion Points
Key Terms
Review Questions
Review Activities
Exploring the Web
References
Suggested Readings
Appendix
Glossary
Index