Study Guide for RSQL Exam #2
Quality Improvement (Module 3)
Know the difference between Quality Improvement and Quality Management. What is nursing’s role
in both?
Quality Improvement
o continual analysis and evaluation of products and services to prevent errors and to
achieve customer satisfaction
o never Stops
o Steps: Identify, assemble, collect, establish, select plan, Evaluate
o Focuses on patient quality and safety
Quality improvement (QI) consists of systematic and continuous actions that lead to measurable
improvements in health related services and in the overall health and/or safety of individual
patients.
How do Economics affect the U.S. Healthcare system? How are QI measures impacted by Economics?
Understand the role of Risk Management. What should nurses do if an error is encountered?
Evidence Based Practice (Module 4)
What is Evidence-Based Practice (EBP)?
An organized method for clinical decision making to provide the most effective care to patients.
Diligent, systematic inquiry or investigation to validate and refine existing knowledge and
generate new knowledge
Goal of EBP: to obtain the best information available and to integrate it into nursing practice.
Ultimate outcome: improved quality of care based on the best practices from research
Steps:
o 0 Cultivate a spirit of inquiry.
o 1 Ask the burning clinical question in PICOT (patient, intervention, comparison, outcome,
and time frame) format.
o 2 Search for and collect the most relevant best evidence.
o 3 Critically appraise the evidence (i.e., rapid critical appraisal, evaluation, and synthesis).
o 4 Integrate the best evidence with one's clinical expertise and patient preferences and
values in making a practice decision or change.
o 5 Evaluate outcomes of the practice design or change based on evidence
o 6 Disseminate the outcomes of the EBP (evidence-based practice) decision or change.
What are the various types of research? Where do nurses find it?
, Information dissemination: Journals, Conferences, Educational programs, Media, Literature
review
The first part of the report should include a structured summary statement of the problem,
practice, or disease that describes what is in the evidence report. The second part should
comprise a lengthy and detailed analysis of the published and unpublished data, including
reviews of articles and reports, the populations included in the studies, and the nature of the
nursing actions investigated. The third, and important, is the ranking of such evidence. After
gathering that information, the nurse must now ask the following:
o Is this the best available evidence? Look for sources that are peer-reviewed and no more
than 5 years old.
o Will the recommendations work for my practice given the client population and
problems? If the study population is of the elderly and the nurse's primary work is with
children, the information may not be applicable.
o Do the recommendations fit well with the preferences, needs, and values of the clients I
serve? If the values of the nurse's primary group vary greatly from those of the study
group, it is likely the recommendations may not work well
Attending conferences and poster presentations in which clinical research findings and ideas for
practice are presented is an excellent way to quickly view the findings and network with the
researchers. Other strategies proposed include conducting research via textbooks and procedure
manuals, connecting research use to a facility's goals, developing committees between colleges
and hospitals, and inviting nurses to present during routine meetings and conferences.
How does research improve practice?
EBP is a priority for all health care providers in order to ensure patient safety.
EBP promotes the use of effective strategies to help patients be well. It also helps nurses prevent
harm to their patients, to themselves, or to the global community. Florence Nightingale is
considered the first person to use research in nursing to elevate it to the status of a profession
(Catalano, 2009). Simple sanitary practices, such as hand washing, were promoted by
Nightingale and became commonplace in modern society.
Rising cost of health care
o By 2008, 15% of the population will be over 65.
o About 45 million Americans do not have health insurance.
o In 2003, healthcare costs totaled $1.7 trillion.
o Healthcare costs as a percentage of the GDP were 15.3%.
o Employee-sponsored health insurance has risen at a rate 5 times faster than wages.
Quality improvement initiatives
o National Quality Forum (NQF)
o See the 30 measures that healthcare organizations can take to improve quality
o National Database of Nursing’s Quality Indicators
o Unit-based repository of quality indicators designed to assist hospitals to make
improvements in quality
Quality Improvement (Module 3)
Know the difference between Quality Improvement and Quality Management. What is nursing’s role
in both?
Quality Improvement
o continual analysis and evaluation of products and services to prevent errors and to
achieve customer satisfaction
o never Stops
o Steps: Identify, assemble, collect, establish, select plan, Evaluate
o Focuses on patient quality and safety
Quality improvement (QI) consists of systematic and continuous actions that lead to measurable
improvements in health related services and in the overall health and/or safety of individual
patients.
How do Economics affect the U.S. Healthcare system? How are QI measures impacted by Economics?
Understand the role of Risk Management. What should nurses do if an error is encountered?
Evidence Based Practice (Module 4)
What is Evidence-Based Practice (EBP)?
An organized method for clinical decision making to provide the most effective care to patients.
Diligent, systematic inquiry or investigation to validate and refine existing knowledge and
generate new knowledge
Goal of EBP: to obtain the best information available and to integrate it into nursing practice.
Ultimate outcome: improved quality of care based on the best practices from research
Steps:
o 0 Cultivate a spirit of inquiry.
o 1 Ask the burning clinical question in PICOT (patient, intervention, comparison, outcome,
and time frame) format.
o 2 Search for and collect the most relevant best evidence.
o 3 Critically appraise the evidence (i.e., rapid critical appraisal, evaluation, and synthesis).
o 4 Integrate the best evidence with one's clinical expertise and patient preferences and
values in making a practice decision or change.
o 5 Evaluate outcomes of the practice design or change based on evidence
o 6 Disseminate the outcomes of the EBP (evidence-based practice) decision or change.
What are the various types of research? Where do nurses find it?
, Information dissemination: Journals, Conferences, Educational programs, Media, Literature
review
The first part of the report should include a structured summary statement of the problem,
practice, or disease that describes what is in the evidence report. The second part should
comprise a lengthy and detailed analysis of the published and unpublished data, including
reviews of articles and reports, the populations included in the studies, and the nature of the
nursing actions investigated. The third, and important, is the ranking of such evidence. After
gathering that information, the nurse must now ask the following:
o Is this the best available evidence? Look for sources that are peer-reviewed and no more
than 5 years old.
o Will the recommendations work for my practice given the client population and
problems? If the study population is of the elderly and the nurse's primary work is with
children, the information may not be applicable.
o Do the recommendations fit well with the preferences, needs, and values of the clients I
serve? If the values of the nurse's primary group vary greatly from those of the study
group, it is likely the recommendations may not work well
Attending conferences and poster presentations in which clinical research findings and ideas for
practice are presented is an excellent way to quickly view the findings and network with the
researchers. Other strategies proposed include conducting research via textbooks and procedure
manuals, connecting research use to a facility's goals, developing committees between colleges
and hospitals, and inviting nurses to present during routine meetings and conferences.
How does research improve practice?
EBP is a priority for all health care providers in order to ensure patient safety.
EBP promotes the use of effective strategies to help patients be well. It also helps nurses prevent
harm to their patients, to themselves, or to the global community. Florence Nightingale is
considered the first person to use research in nursing to elevate it to the status of a profession
(Catalano, 2009). Simple sanitary practices, such as hand washing, were promoted by
Nightingale and became commonplace in modern society.
Rising cost of health care
o By 2008, 15% of the population will be over 65.
o About 45 million Americans do not have health insurance.
o In 2003, healthcare costs totaled $1.7 trillion.
o Healthcare costs as a percentage of the GDP were 15.3%.
o Employee-sponsored health insurance has risen at a rate 5 times faster than wages.
Quality improvement initiatives
o National Quality Forum (NQF)
o See the 30 measures that healthcare organizations can take to improve quality
o National Database of Nursing’s Quality Indicators
o Unit-based repository of quality indicators designed to assist hospitals to make
improvements in quality
