Sustainability in Quality Improvement and Patient Safety Initiatives

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term \u27evaporation of improvements\u27 addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & Ketley, 2007). This article addresses the components of what makes a quality initiative sustainable by applying a framework developed that identifies components necessary within a sustainable quality initiative evident from the development process through to the implementation phase of the initiative which becomes part of the fabric of an organization

Commentary on Child Welfare Workers’ Perceptions of the Influence of the Organizational Environment on Permanency Decisions for Families

Invited commentary on Child Welfare Workers’ Perceptions of the Influence of the Organizational Environment on Permanency Decisions for Families

Rola pielęgniarki w poprawie jakości i bezpieczeństwie pacjenta

The role of nurses as health professionals var-greatly throughout the world. What is constant for all nurses is that the nursing profession is expected and committed to serve society and provide high quality and safe health care to all recipients of health care. To that end, safety and quality initiatives are underway across the globe to achieve the best health care outcomes possible based on the implementation of scientific evidence and best evidence-based clinical practices available. The purpose of this paper is to explain how safety and quality improvement (QI) initiatives achieve high quality outcomes for patients and how an understanding of the relationships among research, evidence-based practice, and QI and the role of the professional nurse in QI helps nursing meet its commitment to achieve the best possible care and outcomes for patients. The Model for Improvement is provided as a scientific methodology for QI initiatives in health care. Nurses understand the processes of care including what works well and what does not, and they have the clinical experience and scientific knowledge needed to improving processes of care that lead to more effective patient outcomes. (JNNN 2019;8(1):30–36)Znaczenie pielęgniarek, jako fachowych pracowników służby zdrowia, jest zróżnicowane w zależności od regionu na świecie. Jednak stałą i niezmienną cechą charakterystyczną dla tego zawodu jest oddana służba społeczeństwu i zapewnienie wysokiej jakości opieki zdrowotnej i bezpieczeństwa wszystkim chorym. W tym celu na całym świecie podejmowane są inicjatywy związane z bezpieczeństwem i jakością, aby osiągnąć najlepsze możliwe wyniki opieki zdrowotnej w oparciu o dowody naukowe i najlepsze dostępne praktyki kliniczne oparte na dowodach. Celem tego artykułu jest wyjaśnienie, w jaki sposób inicjatywy poprawy bezpieczeństwa i jakości (QI) wpływają na poprawę jakości opieki nad pacjentem oraz jak zależności między badaniami naukowymi, praktyką kliniczną opartą na dowodach oraz rolą pielęgniarki w QI wpływają na realizację zadań pielęgniarki w celu osiągnięcia jak najlepszej opieki i wyników dla pacjentów. Ten model poprawy stanowi metodologię naukową dla inicjatyw QI w opiece zdrowotnej. Pielęgniarki doskonale znają wady i zalety mechanizmów funkcjonujących w opiece zdrowotnej i potrafią doskonale wykorzystywać doświadczenie kliniczne i zdobytą wiedzę naukową w celu poprawy świadczonych usług mających na celu poprawę jakości opieki nad pacjentem. (PNN 2019;8(1):30–36

The Development and Implementation of Evidence-Based Preanesthesia Assessment Tools for LVAD Patients Undergoing Non-Cardiac Procedures

Abstract A university-affiliated tertiary medical center with a newly developed Advanced Heart Failure and Mechanical Circulatory Support program identified the need to implement a more systematic approach to the preanesthesia assessment process for patients with a Left Ventricular Assist Device (LVAD) undergoing noncardiac procedures and standardized guidelines to determine the best blood pressure monitoring system for patients with an LVAD during these noncardiac procedures. A multidisciplinary panel of clinical experts developed an LVAD Preanesthesia Toolkit using standard recommendations identified via evidence-based literature and expert opinion. The Toolkit included an LVAD Preanesthesia Assessment (VaPA) tool and an LVAD Blood Pressure Monitoring Decision Tree. The Toolkit initiative utilized a checklist to promote safety and enhance access to LVAD-specific resource tools for anesthesia providers. An online education module outlining the details of the initiative was distributed to targeted users prior to a pilot implementation of the VaPA tool into clinical practice. Data collection concerning education dissemination revealed that 27.2% of anesthesia providers had reviewed and verbalized their understanding of the initiative. An analysis of the effectiveness of the VaPA tool was conducted in a 5-month retrospective review of electronic health records for LVAD patients undergoing noncardiac procedures. Outcome data revealed 100% accuracy in preanesthesia assessment documentation. Results indicated improved consistencies in documenting the LVAD specific components of the preanesthesia assessment

From the Editors-in-Chief

The Co-editors in chief welcome The Journal of Nursing & Interprofessional Leadership in Quality and Safety to state what the purpose of the journal is and why it is important for this journal to start

An Assessment of the Human Papillomavirus Immunization Knowledge, Practices, and Prevention Among a Cohort of Urban College Students

Human papillomavirus (HPV) is the most common sexually transmitted disease, yet little is known about the college-age knowledge and prevention practices related to HPV. Although sample vaccination rates mirrored national known vaccination rates, a majority of participants did not complete the three dose vaccine schedule. HPV knowledge was similar between males and females while males were more likely to engage in preventative practices. This information can help healthcare providers reinforce vaccination schedule and prevention practices

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Comparing Student Satisfaction with Two Types of Reusable Learning Objects in an Online Course Nurse Practitioner Course

The use of reusable learning objects in online nursing education is not new, but few studies have compared different types of learning objects. This study is a comparison of two types of learning objects in sample of nurse practitioner students to help illuminate the more effective type from the student perspective. Data were collected using an online standardized survey for evaluating learning objects. Statistical differences between the students' satisfaction rating with the two types of learning objects were minimal. Informative information resided in the narrative responses for each type of learning object. Student responses reflected that the interactive learning objects were helpful in learning the content, but familiarity with the delivery method and technical issues were barriers, particularly for the interactive learning objects. The findings provide essential baseline information for further study in the most effective learning object type for online education