Nursing Quality & Safety

Absorptive capacity is positively correlated to quality improvement in hospitals and predicts the success with which hospitals can improve and sustain quality. The conceptual framework of absorptive capacity is applied against the contextual backdrop of organizational learning theory to provide a better understanding of the predictability of quality improvement by potential absorptive capacity (PACAP) and realized absorptive capacity (RACAP). This study is important as it will expand previous research and help hospital administrators as they continue to lead their organization’s QI efforts. The purpose of this nonexperimental, quantitative research was to assess whether AC is predictive of QI in U.S. hospitals. Secondarily, this study examined whether PACAP or RACAP was predictive of QI in U.S. hospitals. Author: Christianna B. Orvis, Northcentral University.

The guiding principles of the Culture of Patient Safety in healthcare include promotion of an environment where teamwork is fostered; there is unfettered communication between team members, and openness about errors. Declining scores on the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety led leadership to look for additional ways to evaluate culture. This quantitative, non-experimental correlational study was carried out in the Pharmacy at Maine Medical Center. The purpose of this study was to understand the underlying organizational culture and any influence that has on the perceptions of the culture of patient safety. Author: Gwen M. Rogers, Northcentral University.

With sepsis being difficult to diagnose due to this mimicking nature of the symptoms to other disease processes, there must be a plan of care introduced to the daily work flow that will notify the care provider of a need to intervene prior to escalation of the sepsis cascade of symptoms. This study will use the quantitative research methodology. The convenience sample will be pulled from a patient population found at a level I trauma center that has approximately 100 medical-surgical level of care beds. The ex post facto design will be used to determine whether the use of a proactive clinical decision alert system versus relying on a passive notification will impact the timeliness of care provided and the mortality outcomes for patients experiencing signs and symptoms of sepsis. Author: Linda Lawson, Northcentral University.

The purpose for this qualitative research was to provide comparative data to determine if there was areas in need of improvement when it pertained to medical errors. Researchers have validated that initiating measures for continuous improvement would minimize error rates and benefit the clinicians and their patients. Patient safety was important and cause major concerns, therefore this research explored categories that influenced decision-making processes or conditions that causes deficit in reasoning, which could have an impact on cognitive abilities. Therefore, medical errors are a research worthy problem; since they cause phenomenon, conflict within managerial processes, and was a contributing factor for malpractice payouts, per a report from 2015 Institute of Medicine. Author: Mary Jane Robinson, Northcentral University.

A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative research study was to examine the relationship between universal quality management standards (ISO 9000) and EHR interoperability in the United States. Electronic health record systems are a pivotal aspect in the establishment of the Nationwide Health Information Network. If a relationship exists between ISO 9000 quality management principles and EHR system interoperability, then the quality management principles would be consistent with Almgren's social justice theory that all citizens have a right to quality health care because EHR interoperability is seen as necessary for the improvement of health care. Author: Bernice M. Purcell, Northcentral University.

The purpose of this qualitative study using case study was to understand the emerging themes from the perceived patterns of behavior, evidence-based practice challenges, and perceived effectiveness of the transformational and transactional healthcare leaders in the United States when responding to the rising cost of healthcare and declining quality. Using semi-structured and open-ended inquiries, this qualitative multi-case study research interviewed 20 hospital leaders throughout America. Author: Ernesto Abarquez Cerdena, Northcentral University.

The Institute of Medicine reported that numerous patients were being harmed in hospitals and service quality and patient safety needed improvement. To address this issue, high reliability organization principles (HROPs) have been suggested as a means to increase reliability in hospitals. The specific problem was that the HROPs have not been implemented in hospitals even though this could help reduce medical errors and improve the quality of patient safety and care. The purpose of this qualitative, exploratory, embedded single case study was to explore hospital leaders’ knowledge of HROPs and perceptions of implementing them within the culture of the hospital to improve patient safety and quality of care. Author: Karen Scott-Martinet, Northcentral University.

The problem addressed in this study was the rising health care costs, particularly the costs due to avoidable prolonged length of stay (LOS). The purpose of this single site comparative quantitative study was to examine the effectiveness of Lean Six Sigma methodologies on reducing the length of stay in nursing units where nurses have adopted the improved process versus nursing units where nurses have not followed the improved process. The data were collected from Nemours’s electronic health record, Epic’s database, by Nemours’s measurement specialist, where post-lean and pre-lean health records were compared. Author: Georgette Loubnan, Northcentral University.

Patient safety remains a global challenge that has required constant resolve to improve personnel skills, responsiveness to detail, and transformational actions. This phenomenological study explored how an operating room's culture of patient safety was affected by the efficacy of its leadership in managing its critical qualitative safety characteristics. Despite the current technological advances and various patient safety measures, studies have reported not only an increasing number of preventable sentinel events, but also recurring mistakes that continue to cause death or serious health complications. Author: Irenaanna Kavanaugh, Northcentral University.

Improving patient safety is a priority for health care providers in the United States; however medical errors remain a persistent problem. A strong patient-safety culture is associated with decreased medical errors. In hospitals, registered nurses are in a position to identify medical errors and communicate their suggestions to improve patient safety. Despite the importance of communication by registered nurses and the potential impact on improved patient-safety culture, these constructs are largely unexamined in the literature. This quantitative, correlational study was designed to investigate the direct and moderating relationships between registered nurses' perception of prosocial voice, self-monitoring, and patient-safety culture in a hospital setting. Structure-process-outcome (SPO) theory guided the study. Author: Sherri Linn Hill, Northcentral University.