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Quality Improvement

Quality Improvement

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Shirey et al (2011) defined quality improvement as the methodical, data-guided actions developed to bring about immediate enhancement in medical care distribution, in particular configurations. They further gave indicators of quality improvement to include; Nursing Sensitive indicators, Performance Measures and Compliance checks. An example is the use of involvement at unit/facility level to make an effort to reduce individual drops. Still on the same note, Polit and Hungler (1995) in Melnyk (2011) defined evidence based research as a methodical search for knowledge about issues of significance to the medical career. An example is experienced when examining of advancement that may affect medical practice in common (i.e. such as outside of the facility), such as to avoid drops or injury from drops or stress stomach problems.

The analysis process includes conceptualizing analyzing, planning and applying concepts, and interpreting the research results. For evidence-based research, the process involves a logical flow as each step builds on the previous steps. These procedures must be involved in published reports to enable readers to comprehend and critique the study. The research process is inclusive of forming a hypothesis, studying the protocols of data collection, analyzing and interpreting the types of data collected and finally getting to implement into actual practice what has been established as part of the findings. Quality improvement is more of a rapid cycle process that deals with careful planning, doing, studying and acting. In determining whether to use quality improvement or evidence based research, the experts must put into considerations the types of interventions needed, the risks involved, the target audience and the data source. The other major differences in these two processes lie in the purposes of the initial study and the underpinnings involved philosophically. It also depends on the target beneficiaries, EBP values, research design and instruments, the risks and burdens involved and the sample size of the population to be studied.

The latest technological development and advancement have affected the medical industry tremendously and transformed the manner in which healthcare services are being provided. The development in technology has advanced the healthcare transition process as medical records can now be stored in electrical formats, compared to the traditional way of handling patients. The Information Technology advancement has changed clinical service provision, the communication process between health service providers and the patients, access of tailor made patients’ content that are meant to suit personal needs and also the cooperation between patients and clinical service providers during the process of self management in conditions deemed to be chronic. Because medical errors are caused by program or procedural challenges, it is important to adopt various process-improvement methods to recognize issues, worthless proper care, and avoidable mistakes to then influence changes associated with systems. Each of these methods includes analyzing efficiency and using results to inform modify. Projects to enhance top quality need to be calculated to demonstrate “whether enhancement efforts (1) lead to modify in the primary end point in the desired direction, (2) contribute to random outcomes in different parts of the program, and (3) require additional efforts to bring a procedure back into acceptable ranges (Melnyk et al).

The Agency for Healthcare Research and Quality (AHRQ), the Nationwide Quality Forum, the Joint Commission, and many other national companies promote the use of valid and reliable actions of top quality and individual protection to enhance medical proper care. Measures of top quality and protection can track the progress of top quality enhancement initiatives using exterior standards. Benchmarking in medical proper care is defined as the continual and collaborative self-discipline of measuring and comparing the outcomes of key work processes with those of the best artists in analyzing business efficiency. There are two types of benchmarking that can be used to evaluate individual protection and top quality efficiency. Inner benchmarking is used to recognize best methods within a company, to evaluate best methods within the company, and to evaluate current practice over time. The information and can be plotted on a management chart with mathematically derived upper and lower management limits. However, using only internal benchmarking does not necessarily represent the best methods elsewhere. Competitive or exterior benchmarking includes using relative information between companies to assess efficiency and recognize improvements that have proven to be successful in other companies.

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Another important aspect which should not be overlooked in the process of quality improvement is the patient centered approach. In this case, the nurses should work closely with patients to ensure health literacy among patients. Healthy People 2010 describe health literacy as the potential to acquire, procedure, and understand primary health details and solutions required to create appropriate health choices. Health literacy is determined as the level to which people have the potential to acquire procedure and understand primary health details and solutions required creating appropriate health choices. Health literacy develops on the idea that both health and literacy are critical resources for existence (Agency for Healthcare Research and Quality, 2011).

The level of literacy directly impacts the capability to not only act on health details but also to take more control of our health as people, families and areas. Information represents primary capabilities required to be successful in community while health literacy needs some guidance, such as those necessary for finding, analyzing and developing health details from a variety of situations. It also needs some understanding of health-related terminology as well as the lifestyle of the health system (Center for Disease Control, 2012). From a nursing perspective, health literacy implies that nurses and physicians will work with patients to explain the choices of medicine and qualities of drugs given. Patients are treated as equal stakeholders whose decisions are highly considered in the process of receiving medical care.

Shirey et al (2011) have pointed out a developing trend of hospital administrators’ adaption and application of the latest technology devices to improve quality in healthcare provision. A variety of state health divisions in the United States, Australia and the United Kingdom are adapting modern medical prescription strategies to improve quality and reduce errors. One such technique that has been adopted is the use of robots in medication. Currently, robots can only distribute medicines by only one technique, either the unique features technique (also known as ‘one stop dispensing’) or the packed down ‘unit doses’ technique. Due to electronic incorporation, electronic automation is incorporated, when the physician recommends the medication on the personal computers, he/she is also writing the brand to affix to the medication. This means the brand is always what the physician asked for. Researchers have established that because the brand is always accurate to the prescribed medication, there often can be no translation related mistake. Drugs can only be saved in the robot by bar rule recognition. There is a direct electronic link between the medication, bar rule, the item selected on the electronic prescribed, and the brand that the

robot is applicable. These are the crucial hyperlinks in drawing protection advantages from technology.


Agency for Healthcare Research and Quality. (2011). Health literacy interventions and outcomes: An updated systematic review. Retrieved from http://www.ahrq.gov/research/findings/evidence-based-reports/literacyup-evidence-report.pdf

Center for Disease Control. (2012). Health literacy. Retrieved from http://www.cdc.gov/healthcommunication/audience/healthliteracy.pdf

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Shirey, M. R., Hauck, S. L., Embree, J. L., Kinner, T. J., Schaar, G. L., Phillips, L. A., & McCool, I. A. (2011). Showcasing Differences between Quality Improvement, Evidence- Based Practice, and Research. Journal of Continuing Education in Nursing, 42 (2), 57- 70. Doi: 10.3928/00220124-20100701-01 Shirey.pdf

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