1. Quality Improvement PNN 351

2. Quality • Meeting or exceeding requirements of customer/client

3. Domains necessary when measuring quality • Structure evaluation- physical facilities, resources, equipment • Outcome evaluation- client’s current status with expected outcomes-looks at direct client care activities, ex. • Clinical pathways • Benchmarking

4. Process evaluation • Measures nursing actions via steps of the Nursing Process- was nursing care adequate, appropriate, effective, efficient? • Nursing audit - collecting and analyzing data to evaluate effectiveness of interventions • Concurrent • Retrospective • Peer evaluation

5. Factors influencing quality movement • Consumer demands • Financial viability • Regulatory requirements- JACHO

6. Legal and ethical implications • Legal- laws and regulations create external structures for quality management. • Failure to comply can result in lawsuits • Ethics- sense of obligation to practice to one’s best ability

7. How is this accomplished? • QA- Quality Assurance- monitoring and evaluation focus on individual performance • Variance reports • CQI- Continuous Quality Improvement- scientific data-driven approaches used to study work processes that lead to long-term system improvements.

8. TQM- Total Quality Management- promotes an organizational culture that supports customer need, empowers employees to work as teams and emphasizes self-development.

9. CPI principles • Quality is a central theme to the organization • Leadership committed to creating organizational culture. • All staff personally responsible for quality • Continual education and training

10. LPN role in CQI • Participate in collecting data • Documentation • Monitor impact • Remain competent in skills