Quality improvement engagement and competence: A comparison between frontline nurses and nurse leaders

Tschannen, Dana; Alexander, Catherine; Taylor, Sarah; Tovar, Elizabeth; Ghosh, Bidisha; Zellefrow, Cindy; Milner, Kerry A.

doi:10.1016/j.outlook.2021.02.008

Cited by 9 publications

(23 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…QI competence: skills . Our findings suggest that, overall, nurses' QI skills proficiency remains low, a finding consistent with previous research 6. Role, education, and years of experience were all statistically significant predictors of QI skills scores.…”

Section: Discussionsupporting

confidence: 90%

“…This study found that role, education, and years of experience were significant predictors of QI engagement. Nurse leaders were significantly more likely to report engaging in QI than APRNs and frontline nurses, a finding consistent with earlier research 6. A possible explanation is that since nurse leaders are responsible for aligning clinical practice and performance measures in the departments they supervise, they might engage more in QI in an effort to meet the organization's goals for care quality 15, 16.…”

Section: Discussionsupporting

confidence: 77%

“…Nurse engagement in quality improvement (QI) has been shown to have a critical impact on clinical processes, patient outcomes, and the overall quality of care 1-4. Yet such engagement, especially among frontline nurses, remains limited 5, 6. In order to fully engage, frontline nurses must possess QI competence—the knowledge, skills, and attitudes that are intrinsic to QI.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Original Research: Exploring Frontline Nurses' Self-Perceived Levels of QI Engagement and QI Competence

Tschannen,

Alexander,

Bidisha

et al. 2023

AJN, American Journal of Nursing

Self Cite

View full text Add to dashboard Cite

Background and purpose: Nurse engagement in quality improvement (QI) is critical in the delivery of safe high-quality care, yet few studies have evaluated frontline nurses in this area. The purpose of this study was to identify and compare levels of self-reported QI engagement and QI competence among frontline nurses and nurse leaders. Methods: This study used a cross-sectional descriptive design. A convenience sample of frontline nurses (bedside RNs and advanced practice nurses) and nurse leaders from acute and ambulatory care sites completed the Nursing Quality Improvement in Practice (NQuIP) tool, which measures engagement and competence (knowledge, skills, and attitudes) in QI. Results: Data from 6,351 surveys completed by frontline nurses and nurse leaders representing 66 sites nationwide were analyzed. Only 52.5% of all respondents reported participating in QI. Knowledge scores were relatively high, while skills scores—especially those related to using QI tools—were low. Overall attitudes toward QI were positive. Nurse leaders scored significantly higher in engagement and competence than the frontline nurses they supervise. Conclusions: The study findings indicate that nurse engagement in QI is limited. Although nurses' knowledge levels appear to be high, their limited competency in QI-related skills may contribute to low QI engagement. Leaders must make efforts to increase nurse engagement in order to attain high-quality outcomes. Using the NQuIP tool will allow leaders to evaluate nurses' self-perceived QI competence and engagement, which will aid in identifying target areas and developing effective strategies for improvement.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 77%

mentioning

confidence: 99%

See 1 more Smart Citation

Original Research: Exploring Frontline Nurses' Self-Perceived Levels of QI Engagement and QI Competence

Tschannen,

Alexander,

Bidisha

et al. 2023

AJN, American Journal of Nursing

Self Cite

View full text Add to dashboard Cite

show abstract

“…Kovner et al (2010) reported that 46% of new nurses (n = 436) had never participated in the QI process. Two more recent studies noted similar results with 46.4% (n = 682) and 47.8% (n = 511) of nurses reporting never having participated in QI, respectively (Djukic et al, 2021;Tschannen et al, 2021). Barriers to nurse participation in QI have included workload, time constraints, unit cultures, resistance to change and leadership support (Djukic et al, 2013;Jeffs et al, 2013).…”

mentioning

confidence: 72%

A qualitative study on barriers and facilitators of quality improvement engagement by frontline nurses and leaders

Alexander

Tschannen

Argetsinger

et al. 2022

J Nursing Management

Self Cite

View full text Add to dashboard Cite

Aim: This study aimed to understand the facilitators and barriers of quality improvement (QI) from the perspective of nurses and leaders at the frontline.Background: Nurse engagement in QI has been associated with quality care and improved patient outcomes, yet nurse reported participation is low.Methods: A descriptive qualitative design and purposive sampling was used to examine barriers and facilitators of nurse engagement.Results: Facilitators (1) A leader's influence on a QI culture. Subthemes: creating buy-in, support of a just culture and working in partnership with nurses. Barriers(1) Barriers in organizational culture for nurses to lead QI. Subthemes: organizational hierarchy, absence of a just culture, nurses' role not valued, lack of accountability for QI in nursing role and resistance to change. (2) Barriers in organisational structure for nurses to lead QI. Subthemes: manager disengagement, time pressures, lack of access to timely data, lack of QI knowledge, siloed departments and lack of QI experts. Conclusion:Barriers to QI engagement prevent nurses from fully engaging in QI. Creating a just culture and building the infrastructure to support nurse engagement is critical for success.Implications for Nursing Management: Specific facilitators and barriers were identified that nurse leaders can assess in their practice setting and use relevant strategies to support engagement in QI.

show abstract

“…As the important component of healthcare system, nurses play a pivotal role in improving medical care and maintaining people’s health. 1 It was found in previous studies that nurses not only help alleviate patients’ pain, 2 but also help cultivate patients’ positive attitude and improve their life quality. 3 However, influenced by the content, nature, environment and cultural concept of nursing, 4 , 5 nurses may suffer the effects of stigma.…”

Section: Introductionmentioning

confidence: 99%

Development of the Nurse Occupational Stigma Scale

Yang¹,

Zhang²,

Leng³

et al. 2022

PRBM

View full text Add to dashboard Cite

Introduction Occupational stigma toward nurses exerts a negative impact on the physical and mental health and work performance of nurses. However, hitherto, there has been no quantitative instrument designed to assess occupational stigma toward nurses. Objective The present study aimed to develop the Nurse Occupational Stigma Scale (NOSS) and test its reliability and validity in the Chinese context. Methods The items of the scale were formed through the open-ended interview and literature review. A questionnaire survey was administered among 765 patients using NOSS and the Caring Behaviors Inventory (CBI-24). Results In the initial questionnaire, a total of 21 items were developed, and 5 items were dropped for cross-loadings. The formal scale consists of 16 items divided into three dimensions of negative label, nurse-patient relationship, and devaluation and discrimination. The results of confirmatory factor analysis (CFA) indicated that the three-factor model fitted well ( χ 2 /df=2.635, RMSEA=0.064, RFI=0.926, CFI=0.962, NFI=0.941, IFI=0.953). The total scores of the NOSS and the scores of all dimensions were significantly negatively correlated with the scores of the CBI-24. The internal consistency coefficients of the scale and all dimensions were between 0.827–0.920, and the split-half reliability coefficients were between 0.826–0.942. The NOSS had the measurement invariance across gender. Conclusion With its good reliability and validity, the NOSS can be an appropriate instrument for researchers to conduct studies about nurse occupational stigma.

show abstract

Quality improvement engagement and competence: A comparison between frontline nurses and nurse leaders

Cited by 9 publications

References 23 publications

Original Research: Exploring Frontline Nurses' Self-Perceived Levels of QI Engagement and QI Competence

Original Research: Exploring Frontline Nurses' Self-Perceived Levels of QI Engagement and QI Competence

A qualitative study on barriers and facilitators of quality improvement engagement by frontline nurses and leaders

Development of the Nurse Occupational Stigma Scale

Contact Info

Product

Resources

About