The Role of CQI and Legal Considerations in Nursing Practice

This report delves into the concept of Continuous Quality Improvement (CQI) in nursing, emphasizing its importance in ensuring high standards of patient care. It explores the collaborative nature of CQI, highlighting the roles of nurse managers and staff nurses in identifying and implementing improvements within healthcare systems. The report also addresses the legal aspects of nursing practice, including the impact of standards of care, federal and state laws, and the responsibilities of nurses when asked to practice outside their specialties. It stresses the importance of specialized knowledge and skills in nursing, emphasizing the need for nurses to be familiar with legal mandates to protect themselves and their patients. The report references various studies to support its arguments, providing a comprehensive overview of CQI and its legal implications in nursing.

ASSIGNMENT 14
A. Continuous quality improvement (CQI) is the responsibility of all
nurses
Continuous quality improvement is a concept which involves and demonstrates quality assurance
with the provision for meeting an appropriate standard. Problem resolution on the other hand,
must include all the departments so that the quality improvement can be made a continuous
process within the organization who works together for producing better services for health care
patients. (Lynn ML, Osborn DP., 1991) suggested to espouse the total system through reform for
achieving quality improvement and he emphasized not just a mere alteration of the existing
system, but radical change of it. As (Charles J. Homer,Peter Forbes, Horvitz, SM; Laura E.
Peterson, David Wypij, Patricia Heinrich, 2005), noted, that the staff who are providing the
services must be assumed to have been acting in good faith and hence they are not failing due to
their deliberate actions. But, the people who are performing direct services are excellently placed
and hence they can identify the need for the desired change within the service delivery processes.
So, the staff nurse being at the center of the system can assess the status and hence can deploy
themselves toward improvement which are provided to clients. Hence, it is desirous of a nurse
manager to structure the work setting in such a way that it facilitates the ability of the staff
nurse's ability for undertaking constructive action and thereby improving care (Kosseff,
ALNiemeier , 2001).
The quality improvement can facilitate and coordinate efforts towards improvement of quality
for achieving success in an effective way by assisting the departments to prepare documentation
across all departments and aggregating those data for demonstrating the requirements to be met
so mandated by the external regulatory agencies, or the insurers, and also through the
professional standards (Batalden P, Smith SD, Bovender JO, Hardison CD., 1989). The nurse
manager or the leader are in to providing the vision so that the necessary resources can be
secured towards the quality improvement efforts of the organization, in order to make it a
success. To inspire and empower the staff towards the improvement, the nurse managers
participate towards the reshaping of the health care environment by playing a vital role, but,
these improvements requires full and active participation of all the involved individuals (Leape
LLKabcenell, AIGandhi, TKCarver, PNolan, TWBerwick DM, 2000). For example, while
monitoring the staffing and dependency of the patient must be aligned to create a quality
improvement and in so doing the implementation will be further helpful for creating the
initiatives towards the long-term care through nursing towards the patient. Again, for aggreging
to an appropriate action plan, the postoperative pain for the surgical patients and the discharge of
them is a plausible example for the responsibility of nurses towards quality improvement.
B. The legal issues involved in asking nurses to practice outside
their specialties
The legal aspects of nursing do have the possible impact in which care gets delivered to patients
by nurses. The environment gets shaped by the legal concerns, which becomes the determining
factor for the nursing is practice and are judged based on the standard of care for nurses. Written

standards of care and guidelines determines how nurses delivers the care. As, the standard of
care is never guideline nor a policy fixed by a particular individual or institution, but is the
embodiment based on the collective knowledge for determining the minimum criteria for
proficiency (Benner, P. E., Malloch, K., & Sheets, V., 2010). Federal and state laws do have the
impact nursing practice along with various other regulatory requirements so imposed. So, to be
aware of the potential for civil and criminal liabilities, nurses must be familiar with the
prescribed mandates, which involves the delivery of patient care (Carroll, R., 2006). So,
familiarization with the legal mandate and the prescribed standards is a must, so when the nurses
are asked to practice outside their specialties they have every right to deny that without being
imparted with the necessary training. The field of nursing requires specialized knowledge along
with skills which will help them to make independent decision- making. As this practice involves
behavior with reasonable attitude so that a judgement cab be reached with the basic sensory or
any other physical capabilities which is required for applying those gathered knowledge, skills or
abilities to make them applicable for creating benefits to the client and also creating a self-
safeguard towards the arising of any malpractice claims (Reising, D. L., & Allen, P. N. , 2007).
References
Batalden P, Smith SD, Bovender JO, Hardison CD. (1989). Quality improvement: the role and
application of research methods . J Health Adm Educ, 577-583.
Benner, P. E., Malloch, K., & Sheets, V. (2010). Nursing pathways for patient safety. Chicago,
IL: National Council of State Boards of Nusing.
Carroll, R. (2006). Risk management handbook for health care organizations. In American
Society for Healthcare Risk Management. San Francisco, CA: Jossey-Bass.
Charles J. Homer,Peter Forbes, Horvitz, SM; Laura E. Peterson, David Wypij, Patricia Heinrich.
(2005). Impact of a Quality Improvement Program on Care and Outcomes for Children
With Asthma. Arch Pediatr Adolesc Med, 464-469.
Kosseff, ALNiemeier . (2001). S SSM Health Care clinical collaboratives: improving the value
of patient care in a health care system. . Jt Comm J Qual Improv, 275-319.
Leape LLKabcenell, AIGandhi, TKCarver, PNolan, TWBerwick DM. (2000). Reducing adverse
drug events: lessons from a breakthrough series collaborative. Jt Comm J Qual Improv,
26321- 26331.
Lynn ML, Osborn DP. (1991). Deming’s Quality Principles: A Health Care Application . Hosp.
Health Serv Adm, 111-120.
Reising, D. L., & Allen, P. N. . (2007). Protecting yourself from malpractice claims . American
Nurse Today, 39-44.