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