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How can I engage the nurses on my unit in quality improvement initiatives?


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Improving nursing-sensitive indicators or organizational indicators with a nursing component requires participation of direct-care bedside nurses. Quality improvement (QI) programs designed by organizational-level experts to improve patient care and driven down from the top will not succeed without buy-in from staff members closest to the patient. It is critical that nurses at the bedside are engaged in QI, carrying out the bundles, protocols, and other processes designed to improve quality and safety. Yet getting direct-care nurses involved in QI is difficult in many hospitals, as bedside nurses complain they are already too busy, they do not have enough staff members to carry out complex QI processes, or they do not feel QI is in the scope of the nursing practice. Nurse leaders must create a culture of engagement in QI, keeping in mind the following concepts:

  • QI must be meaningful to nurses and not seen as just a regulatory requirement • QI must be linked to professionalism
  • The processes used in the protocols must be driven by best practice, and nurses must be able to see a direct link between nurse interventions and patient outcomes
  • Nurses must understand (and accept) the data
  • Nurses must be involved in the process of improvement and in identifying the interventions, action plans, and monitoring
  • Nurses must see their efforts rewarded with improved data

Cynthia Barnard, MBA, MSJS, CPHQ

(June 2010)