Patient Safety and Quality: An Evidence-Based Handbook for Nurses

A new resource for nurses that shares evidence-based practices for providing safe, high - quality care is now available from AHRQ. The new 3-volume book, Patient Safety and Quality: An Evidence-Based Handbook for Nurses has been created in collaboration with the Robert Wood Johnson Foundation and examines the issues involved in providing high - quality and safe care across a variety of health care settings, from hospitals to clinics to nursing homes. AHRQ nurse researcher Ronda Hughes served as editor of the book.

Nurses have a vital role in improving the safety and quality of patient care. The book offers proven strategies and interventions they can use to enhance patient outcomes. There are six main sections in the book:

• patient safety and quality
• evidence-based practice
• and patient-centered care
• work environment for nurses
• patient safety and quality improvement
• tools for quality improvement and patient safety that nurses can readily use in practice

Each chapter includes a background section and an analysis of the literature. At the end of each chapter, nurses will find two critical components: The first, Practice Implications, shows how the evidence can be used to make practice changes and Research Implications outlines key research gaps that nurse researchers can target. It is useful for clinicians as a guide when making health care decisions and improving care delivery. Also, faculty and graduate students will also find questions and issues that can be used to develop dissertation topics. Also, researchers might be interested in the research implications sections because they really highlight areas we need to study further to improve care.

The book should also be used by other clinicians and researchers. The majority of the information presented in this book does not appear anywhere else. For instance, the chapters on medication reconciliation, error reporting and disclosure and quality improvement methods offer the first systematic reviews in these areas. Also, with the growing demand to improve care quality, for example the new never events that Centers for Medicare & Medicaid Services will be putting in place October 1, such as health care associated infections and patient falls with injury and also addressed in this book.

Patient Safety and Quality: An Evidence-Based Handbook for Nurses, is available online at ahrq.gov/qual/nurseshdbk/. You can also order the handbook as a searchable CD-ROM or in a three-volume printed set. To order, contact the AHRQ Publications Clearinghouse at 1-800-358-9295 or via e-mail at AHRQPubs@ahrq.hhs.gov.

"3T's Road Map to Transform Health Care

"A recent JAMA commentary examines struggles in the U.S. health system to deliver high-quality care and improved health outcomes due to the systematic failure of discoveries to reach patients in a timely fashion. This commentary written by AHRQ authors, Denise Dougherty, Ph.D., and Patrick H. Conway, M.D., propose a new model, The 3T’s Road Map, to transform the U.S. health care system to accelerate the pace at which innovations are implemented in clinical settings by addressing the “how” of health care delivery. This road map is essential to outline the activities, participants, investments, and fundamental shifts required to create and sustain an information-rich and patient-focused health care system that reliably delivers high-quality care." [from AHRQ Electronic Newsletter]

To view the full commentary:
Dougherty, D., & Conway, P. H. (2008). The "3T's" road map to transform US health care: The "how" of high-quality care. JAMA: The Journal of the American Medical Association, 299(19), 2319-2321. doi:10.1001/jama.299.19.2319

The nursing shortage: A look at the Nurse Funders Collaborative

"Despite consistent public and private investments in nursing over several decades, nurse shortages persist, appearing more acute today than ever before. The Nurse Funders Collaborative, a group of foundations, government agencies, and corporations convened by the Robert Wood Johnson Foundation, has been meeting since 2003, seeking opportunities to address issues facing nursing and health care more strategically. This paper reports on a study conducted under the collaborative’s auspices, which highlights the categorical and regional funding patterns of funders of nursing over five years. This information provides nursing funders with ways to craft new solutions to the nurse shortage." [Abstract from article]


To see the full article:
Davis, D. A. and Napier, M. D. (2008). Strategically Addressing The Nurse Shortage: A Closer Look At The Nurse Funders Collaborative. Health Affairs 27: 876-881

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

"Nurses play a vital role in improving the safety and quality of patient care—not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes.

To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality—Patient Safety and Quality: An Evidence-Based Handbook for Nurses." [From http://www.ahrq.gov/qual/nurseshdbk/]

Experts in the field reviewed the literature, and their contributions are grouped into these sections:

• Patient Safety and Quality
  
• Evidence-based Practice
• Patient-centered Care
• Working Conditions—Work Environment
• Critical Opportunities for Patient Safety and Quality
• Tools

Each section contains a number of subsections, each accessible as an online PDF file that can be printed out. The see the list of topics within the Handbook visit Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043).

Outcomes of Maternal Weight Gain

A new AHRQ evidence report, Outcomes of Maternal Weight Gain, finds that women who gain more or less than recommended amounts of weight during pregnancy are likely to increase the risk of problems for both themselves and their child. However, researchers concluded that the existing body of research is inadequate to permit objective assessments of the range of harms and benefits that would arise from providing all women—irrespective of age, race or ethnicity, or their body mass index before they became pregnant—with the same recommendations for weight gain in pregnancy. Select to review an abstract of the report.

Nurses professional concerns: 1900-2005

A study was recently published "to broaden the context for understanding nurses' professional concerns as voiced through letters to the editor of the American Journal of Nursing from 1900 to 2005. Two issues from each year were randomly selected. Line-by-line analysis was used to code, categorize, and analyze the data. The following five themes emerged: self-care versus self-sacrifice; nursing's emphasis on holistic care; educational and professional preparation; nurse-physician relationships; and the image of the nurse. The recurrent nature of these themes has important implications for nursing education, clinical practice, leadership, and research." [From PubMed abstract]

To see the full article:
Anthony MJ, Barkell NP. (2008) Nurses' professional concerns: letters to the editor for 1900-2005. J Prof Nurs. 24(2):96-104.

Magnet Recognition

"Magnet status is an award given by the American Nurses’ Credentialing Center (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. A Magnet hospital is stated to be one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals are supposed to have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment." [from The Center for Nursing Advocacy]

"The Magnet Recognition Program is based on quality indicators and standards of nursing practice as defined in the American Nurses Association's Scope and Standards for Nurse Administrators (2004). The Scope and Standards for Nurse Administrators and other “foundational documents” form the base upon which the Magnet environment is built. The Magnet designation process includes the appraisal of qualitative factors in nursing. These factors, referred to as “ Forces of Magnetism” were first identified through research done in 1983.

The full expression of the Forces embodies a professional environment guided by a strong visionary nursing leader who advocates and supports development and excellence in nursing practice. As a natural outcome of this, the program elevates the reputation and standards of the nursing profession." [from AANC]

The next generation model for the Magnet Recognition Program ® has been unveiled. "This new model is designed to provide a framework for nursing practice and research in the future, as well as serving as a road map for organizations seeking to achieve Magnet recognition. ... To provide greater clarity and direction, as well as eliminate redundancy within the Forces of Magnetism, the new model configures the 14 Forces of Magnetism into 5 Model Components. The new, simpler model reflects a greater focus on measuring outcomes and allows for more streamlined documentation, while retaining the 14 Forces as foundational to the program." [from AANC]

For a view of the model, and to read more about the model see A New Model for AANC's Magnet Recognition Program ®