Misplacing Our Focus on Quality Improvement

Gold_StarBy Maureen Shawn Kennedy, AJN editor-in-chief

I welcome manuscripts written by nurses in clinical practice, especially comprehensive updates on managing a clinical syndrome or a common problem that readers would find informative and interesting. I call these the “meat and potato” papers—the ones that provide substantial content, the need-to-know information that will help nurses provide quality, evidence-based care. The best ones discuss the physiology and pathology underlying clinical symptoms, practice implications for ongoing monitoring and management, and patient and family teaching and concerns.

The other papers I value are those that describe quality improvement initiatives or processes that improve outcomes and, by following the SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines, are sufficiently detailed so that others can replicate them. (For information on what we seek to publish, see a recent blog post.)

Lately, though, I’m seeing more and more submissions that are not so much focused on how to use best practices to improve care, but rather on ways to improve scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The authors typically describe the impetus for the improvement as low scores, get administrative support to set benchmarks for improving scores, and define success as improved scores. Often the changes are clinically insignificant but scores increase, so everyone is happy.

While the HCAHPS is a national measure that has been adopted as a measure of quality, it’s important to keep in mind that it measures […]

2016-11-21T13:07:44-05:00April 24th, 2013|nursing perspective|1 Comment
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Article Types, Topics of Interest, and Other Considerations for Prospective AJN Authors

iPad app exhibit AORNBy Maureen Shawn Kennedy, AJN editor-in-chief

I recently wrote a post that attempted to give readers a clearer sense of what we are looking for in article submissions and what we are not looking for: “My Professor Said to Submit My Paper (We Hope They Also Told You This).”

This post will just provide a quick overview of the types of articles we publish, as well as a plug for why it’s good to be published in AJN.

In terms of impact factor, AJN ranks 29/95 among ranked nursing journals, with an impact factor of 1.119. (Nursing journals with higher impact factors tend to be specialty research journals, whereas AJN publishes a broad range of content in addition to research, and for a variety of audiences.) Through our robust print, digital, iPad, institutional, and social media channels, AJN reaches more nurses than any other nursing journal.

We publish original research, quality improvement (QI), and review articles as primary feature articles and as CE articles. We also publish shorter, focused columns. All submissions must be evidence based and are peer-reviewed.

Clinical features should cover epidemiology, pathology, current research/“what’s new” in knowledge and/or treatment, nursing implications. There is no specific limit for word count, though feature articles are usually in the range of 6,000 to 10,000 words. (We have done two-part and three-part series for larger papers.) For examples of feature articles, see any of the CE articles on our Web site, […]

2016-11-21T13:08:08-05:00March 14th, 2013|nursing research|0 Comments
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So What? An Invitation to Nurses To Tell Us How They’re Translating Research into Practice

By Inge B. Corless, PhD, RN, FAAN, professor at the MGH Institute of Health Professions, Boston, and Brian Goodroad, DNP, RN, AACRN, nurse practitioner and associate professor at Metropolitan State University in Minneapolis–St. Paul, Minnesota

by centralasian/via Flickr

Crossing the Quality Chasm, an Institute of Medicine report from 2001, bemoans the chasm between our current research knowledge and the current state of care. Back in 2003, Don Berwick, now the Administrator of the Centers for Medicare and Medicaid Services, provided the following pithy codification of the problem in a JAMA article called “Disseminating Innovations in Health Care” (subscription required; click here for the abstract): “Failing to use available science is costly and harmful; it leads to overuse of unhelpful care, underuse of effective care, and errors in execution.” Berwick pondered the slow pace of innovation adoption and attributed it to three factors:

  • the characteristics of the innovation
  • the characteristics of the potential adopters
  • contextual factors

Berwick also made this observation about innovations that do get adopted: “Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all.”

Given these obstacles, what can be done to facilitate the integration of research findings into practice? What can be done to change this situation, and what would this entail?

One step is to […]

2017-05-27T10:28:00-04:00June 17th, 2011|nursing perspective, nursing research|1 Comment
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Taking Charge Seriously

By Christine Moffa, MS, RN clinical editor      

Most hospitals have charge nurses, although how they’re selected and what they do varies not only between hospitals but often between units in the same hospital. For instance, the first time I was in the role of charge nurse it was because none of the usual suspects were working that day! And my manager’s parting words were, “Looks like you’re getting baptized with fire. Good luck.” Thanks to the work of a quality improvement team, the nurses at New York-Presbyterian/Weill Cornell Medical Center in New York City won’t have to go through what I did.

This month’s Cultivating Quality column, An Evidence-Based Approach to  Taking Charge, “describes the planning, implementation, and evaluation of a charge nurse initiative in a large academic medical center.” After reviewing the literature and identifying issues through the use of focus groups, members signed up for different quality improvement teams to develop solutions and action plans.

            The following are some of the changes implemented by the teams:

  • The development of charge nurse core competencies and a definition of the role to be used hospital wide.
  • A standardized hand-off report to be used between charge nurses going off and on shift.
  • An orientation workshop using interactive case scenarios.

See the full article for a list of the charge nurse core competencies as well as an example of a case study used during the interactive workshop. Here’s a breakdown of the charge nurse role and its responsibilities:

2016-11-21T13:15:27-05:00October 6th, 2010|career, nursing perspective, nursing research|3 Comments
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Nurses to Obama: “Don’t Love Us – Just Put Us at the Table”

Mason told the conference that she was disappointed in the remark because “that’s not what nurses need.” Nurses need to be respected for what they know and for what they do, and then they need to be given a seat at the policy table when strategies for changing the health care system are being discussed.

2016-11-21T13:21:56-05:00October 6th, 2009|career, health care policy, nursing perspective|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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