Journal of nursing care quality
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Preliminary data developed by the Health Care Financing Administration under its pilot cooperative cardiovascular screening project indicate that 50 percent of Medicare heart attack patients arriving in emergency departments who are appropriate for thrombolytic therapy do not receive it within the time period specified by the American College of Cardiology. Indicators developed for quality assurance monitoring and evaluation of a hospital emergency department prompted closer review of some cases. It was determined that a critical outcomes team using the principles of total quality management and the FOCUS-PDCA models should be empowered to deal with these issues. Through this process, the need for the development of a chest pain center at the hospital was identified and supported.
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A comprehensive approach to the delivery of family-centered care in the neonatal intensive care unit (NICU) requires that parental perceptions of caregiving be addressed. The Parent Feedback Questionnaire is based on researched needs of NICU parents. ⋯ Ongoing feedback from parents is obtained and incorporated into a planned multidisciplinary continuous quality improvement program. Evaluation of data has resulted in planned interventions to reduce sources of stress and dissatisfaction for parents.
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Development of valid and reliable instruments to assist nurse researchers and clinicians in meeting the needs of consumers is an avenue toward continuous quality improvement (CQI). This article explains validity and reliability and the process of constructing a valid and reliable scale. The development of the Consumer Emergency Care Satisfaction Scale, a measure of quality nursing care in the emergency department, is used as the example.
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A 320-bed surgical nursing department's pain management quality improvement initiative is presented. Clinical indicators were designed through literature review and consultation with pain management experts. Results for pain assessment compliance, patient perception of relief, and the perceived impact of pain on activity--analyzed by nursing care unit, physician service, and pain medication type--are detailed, as are selected strategies to improve pain management outcomes.
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This article describes the development of a quality improvement program for a clinical nurse specialist department reflecting the 10-step process described by the Joint Commission on Accreditation of Healthcare Organizations. The philosophy of continuous improvement has allowed the department to promote concurrent improvements as well as to measure and monitor selected direct and indirect patient care indicators. ⋯ Identified opportunities for improvement, and the changes which occurred to address those opportunities, are also described. Information regarding data collection related to resource consumption and increased collaboration with other departments, is also described.