When It Really Counts: The Art of Matching Nurse Staffing to Nurse Workload.

Methods: The NWA was evaluated using both quantitative and qualitative methods. The American Nurses Association's Principles for Nurse Staffing provided a conceptual framework with 5 core principles: healthcare consumer, interprofessional teams, workplace culture, practice environment, and evaluation.

Results: Units met average staffing needs based on NWA 96% to 99% of the evaluation period.

Implementing a Care-Based Nursing Workforce Model: Implications for Missed Care, Teamwork, and Satisfaction.

Background: Nursing care delivery models may serve as a significant factor contributing to nurse satisfaction, frequency of missed care, and patient outcomes.

Local Problem: The nursing leadership team at our institution sought to determine if an adaptation of our primary registered nurse (RN) nursing model would enhance satisfaction of bedside nurses and care of patients.

Methods: An improvement study introducing a care-based delivery model was implemented between January 2023 and January 2024 on a medical-surgical neurology/spinal unit at our organization.

Using Brainstorming and Affinity Diagramming for Recommending a Care-Based Nursing Workforce Model.

Background: Nursing care delivery models influence nursing workload.

Problem: Poorly designed nursing workforce models may lead to lack of satisfaction in practice, inability to recruit staff, and nursing turnover.

Approach: This paper describes a process that our team undertook to evaluate one nursing unit's nursing care delivery model and provides a recommendation for a nursing workforce model that ensures practice to top of scope while maintaining a balanced workload.

Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE): An Evidence-Based Wellness Program.

Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team.

Key Strategies to Publishing Your Quality Improvement Work.

Background: Improving quality and safety is a goal in health care, and sharing quality improvement (QI) work with internal and external audiences is key to spreading knowledge and ideas for change. Peer-reviewed journals are interested in manuscripts reporting QI work.

Methodology: Although QI work is methodologically different from traditionally published research articles, it can be publishable if conducted in a way that is scholarly and well-planned.

The QSEN Competency Legacy Threaded Through the Entry-Level AACN Essentials: Shaping the Future.

Background: For the last 17 years, the Quality and Safety Education for Nurses (QSEN) prelicensure competencies and knowledge, skill, and attitude (KSA) statements were integrated into nursing curricula.

Problem: With the publication of the competency-based American Association of Colleges of Nursing (AACN) Essentials , it is important to determine the overlap of the QSEN competencies.

Approach: We developed a QSEN-AACN prelicensure crosswalk to help faculty map and integrate the 2021 AACN Essentials into their curriculum.

Successful de-implementation of an ineffective practice: The fall of docusate.

Background: Reducing wasteful practices optimizes value in medicine. Docusate lacks treatment efficacy yet is widely prescribed. This quality improvement project aimed to de-implement docusate in place of a new evidence-based order set.

Reducing hospital acquired pressure injury in a learning health center: Making the case for quality.

Introduction: The purpose of this descriptive study is to examine a learning health system (LHS) continuous improvement and learning approach as a case for increased quality, standardized processes, redesigned workflows, and better resource utilization. Hospital acquired pressure injuries (HAPI) commonly occur in the hospitalized patient and are costly and preventable. This study examines the effect of a LHS approach to reducing HAPI within a large academic medical center.

Curriculum Mapping Post-Baccalaureate Registered Nurse Residency Curriculum to Accrediting Agency Standards.

This article examines the process of mapping a post-baccalaureate registered nurse residency curriculum with Commission on Collegiate Nursing Education standards for nurse residencies. Curriculum mapping revealed gaps and redundancies in the curriculum as well as documented compliance with accreditation standards. Curriculum mapping is instrumental to developing, evaluating, and refining curricular elements.

Value of Using a Structured Improvement Approach: A Dedicated Education Unit Exemplar.

Using a structured approach to improvement that integrates methodological frameworks and commonly used improvement tools and techniques allows an improvement team to systematically implement and evaluate an intervention. Authors from one academic medical center will describe our four-step structured improvement approach in the design of a dedicated education unit (DEU) pilot to potentially meet a critical post-COVID-19 workforce need. Using our structured improvement approach, we successfully piloted a DEU with a unit-based clinical educator and 16 nursing students over 26 clinical days and received 13 preintervention surveys from participants.

Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes.

Goal: The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022.

Methods: We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022.

Anosognosia for Hemiplegia and Falls After Stroke: A Prospective Correlational Study.

Purpose: The aim of this study was to explore the association between the presence and severity of anosognosia for hemiplegia (AHP) and falls in stroke survivors.

Design: A prospective, correlational research design was utilized.

Methods: Primary instrumentation included demographic information and the Visual-Analogue Test for Anosognosia for motor impairment (VATA-m).

Utilization of Improvement Methodologies by Healthcare Quality Professionals During the COVID-19 Pandemic.

Introduction: This study describes the work of healthcare quality professionals during the COVID-19 pandemic, highlighting the successes and challenges they faced when applying their expertise in performance and process improvement (PPI) to help manage the crisis.

Methods: The researchers performed a descriptive analysis of anonymous survey data collected from members of the National Association for Healthcare Quality professional community who were asked about their improvement work during the pandemic response.

Results: Most survey respondents used improvement methods to a great or moderate extent to measure what was happening (83%), rapidly review processes and practice (81%), and decide where to focus effort (81%).

Improving Obstuctive Sleep Apnea Care in the Postanesthesia Care Unit.

Purpose: The purpose of this quality improvement project was to improve care of obstructive sleep apnea (OSA) patients through increased staff recognition of OSA in the postanesthesia care unit (PACU).

Design: Retrospective chart review with implementation of best practice guideline form to front of patient's chart.

Methods: Baseline data were collected during June 2020.

Clinical Team Training and a Structured Handoff Tool to Improve Teamwork, Communication, and Patient Safety.

Background: Effective communication among healthcare teams is essential for ensuring handoff-related safety and quality care outcomes.

Purpose: The aim of this project was to improve patient safety through the reduction of communication-related errors on an acute hemodialysis unit (AHU) in an academic medical center. A target was set to reduce by 50 percent the communication-related errors using strategies to improve teamwork and communication.

Modeling Patient Risk for Hospital-Acquired Pressure Injuries During COVID-19: A Retrospective Study.

Background: COVID-19 negatively impacts many organ systems including the skin. One of the most significant skin-associated adverse events related to hospitalization are pressure injuries.

Purpose: The aim of this study was to determine 8 risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic.

Why Competency Standardization Matters for Improvement: An Assessment of the Healthcare Quality Workforce.

Healthcare transformation requires a healthcare quality workforce with the requisite expertise to lead, oversee, and implement positive change within healthcare organizations. The National Association for Healthcare Quality (NAHQ) Competency Framework, which spans 29 competencies across 8 domains of healthcare quality, outlines the specific knowledge and skills needed to advance personal and organizational quality goals. This study describes 1,671 responses to the NAHQ Professional Assessment survey from a diverse group of healthcare quality professionals representative of NAHQ's professional community.

Medication administration errors: A concept analysis.

Aim: To provide an analysis of the concept of medication errors that occur during the nursing task of medication administration.

Background: Medication errors occurring during medication administration have an increased risk for an adverse patient outcome. Many terms are associated with medication errors, with limited clarification for a medication administration error at the point of care delivery.

Value of Interprofessional Education: The VA Quality Scholars Program.

Interprofessional collaboration (IPC) has been shown to improve healthcare quality and patient safety; however, formal interprofessional education (IPE) training is insufficient. The VA Quality Scholars (VAQS) program exists to develop interprofessional leaders and scholars in healthcare improvement. The purpose of this study was to examine the impact of integrating interprofessional healthcare learners and designing an interprofessional curriculum for the national VAQS program.

Innovations in Evaluating Nursing Academic Practice Partnerships.

Academic-practice partnerships are formalized relationships encouraged by the American Association of Colleges of Nursing to meet healthcare and societal needs. While Academic-practice partnerships have existed for decades, the process for evaluating their outcomes often lacks a robust, standardized structure. The purpose of this article is to describe one organization's process for developing and implementing an evaluation blueprint for appraising an Academic-practice partnership.

Learning During Crisis: The Impact of COVID-19 on Hospital-Acquired Pressure Injury Incidence.

The impact of COVID-19, on the health and safety of patients, staff, and healthcare organizations, has yet to be fully uncovered. Patient adverse events, such as hospital-acquired pressure injuries (HAPIs), have been problematic for decades. The introduction of a pandemic to an environment that is potentially at-risk for adverse events may result in unintended patient safety and quality concerns.

Nurse Burnout Predicts Self-Reported Medication Administration Errors in Acute Care Hospitals.

Background: Every one out of 10 nurses reported suffering from high levels of burnout worldwide. It is unclear if burnout affects job performance, and in turn, impairs patient safety, including medication safety. The purpose of this study is to determine whether nurse burnout predicts self-reported medication administration errors (MAEs).

Developing Leaders and Scholars in Health Care Improvement: The VA Quality Scholars Program Competencies.

Despite the need for leaders in health care improvement across health professions, there are no standards for the knowledge and skills that should be achieved through advanced interprofessional health care improvement training. Existing health care improvement training competencies focus on foundational knowledge expected of all trainees or for specific career pathways. Health care improvement leaders fill multiple roles within organizations and promote interprofessional improvement practice.

Transitional Care Home Visits Among Underserved Patients With Heart Failure.

Heart failure (HF), a global public health problem affecting 26 million people worldwide, significantly impacts quality of life. The prevalence of depression associated with HF is 3 times higher than that of the general population. Evidence, though, supports the use of transitional care as a method to enhance functional status and improve rates of depression in patients with HF.

Implementation of the Clinical Nurse Leader Role in the Veterans Health Administration.

The Veterans Health Administration (VHA) led implementation of the Clinical Nurse Leader (CNL) role nationally with the goal to meet system needs for strong clinical leadership across all settings. After a decade of CNL role implementation, the VHA supported this evaluation to determine the current state, the successes, the challenges, and the fidelity to the original intent of the role. The team used mixed methods to evaluate the state of the CNL initiative.