Analysis of Quality and Safety Measures in Nursing Science (DNP-835)

This report defines quality and safety measures as tools to quantify healthcare processes and outcomes, emphasizing their vital role in nursing science. It highlights how these measures identify disparities, improve accountability, and enhance care delivery. The report provides a contemporary example of applying structure quality measures, such as staff-patient ratios, and patient-reported outcomes through consumer assessments. Furthermore, it analyzes the components needed to analyze healthcare program outcomes, including the Plan-Study-Act (PDSA) model and the Toyota Production System, emphasizing their roles in improving healthcare processes, identifying errors, and enhancing patient safety. The report references studies that highlight the application and effectiveness of these measures in the healthcare setting. This comprehensive analysis underscores the significance of quality measures in ensuring patient-centered care and fostering continuous improvement within the nursing profession.

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Quality Measures
Student’s Name
Institution Affiliation

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Quality Measures
1. Define quality or safety measures and describe their relationship and role in nursing
science today.
Quality measures which are sometimes called performance measures are those tools that
are used to quantify the processes, systems, patient perception and outcomes of healthcare
(Lindly et al., 2017). According to (Singh & Sittig, 2015), the main aim of quality measures is to
identify opportunities that can be used to improve patient care. The nursing field is the practice
that aims to provide care to the patients and ensure a healthy society. Since quality measures
quantify the outcomes of healthcare to realize the opportunities in care delivery, it means that
these measures seek to enhance care delivery by strengthening the healthcare systems which
makes them related to nursing.
Quality measures play a vital role in nursing. First, through quality measures, all the
disparities in healthcare delivery can be identified and appropriate measures applied to address
these measures. This is so because quality measures can be used to measure the patient-reported
outcomes regarding the healthcare they have received (Lindly et al., 2017). The patient-reported
outcomes include the quality of life, health status, and health behaviors. By measuring these
outcomes, healthcare professionals can identify the regions with poor healthcare outcomes such
as the regions where most people are experiencing poor quality of life and also practicing
unhealthy behaviors. The healthcare professionals will then find reasons why these regions are

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reporting poor healthcare outcomes as compared to other regions and come up with appropriate
measures of addressing the same.
Also, quality measures improve accountability in nursing. Accountability in healthcare is
defined as the ability of the healthcare professional to take responsibility for his actions by
ensuring that all tasks assigned to him are done effectively putting the interests of clients first
(Singh & Sittig, 2015). Achieving accountability in nursing has been a big challenge as shown
by the increasing number of deaths as a result of the negligence of the nurses recently. For
example, in the US alone, more than 250000 are reported to die every year as a result of medical
negligence making it the third cause of death in the United States (Lindly et al., 2017). The main
reason for the increased cases of medical negligence is the lack of accountability on the part of
nurses. However, through quality measures, weaknesses that may hinder nurses from performing
their duties effectively can be identified and addressed appropriately. This will enhance
accountability in care delivery because it means that nurses effectively carry out their duties
taking into consideration the interests of patients.
2. Provide a contemporary example of how quality or safety measures are applied in
nursing science.
As earlier mentioned, nursing science deals with the principles of application of nursing and
its related services such as care delivery. Different types of quality measures are currently
applied in nursing science to ensure that care is delivered to people who need it on a timely basis.
One of these types of quality measures is structure. Structure quality measure refers to those
measures in healthcare that assess infrastructure and other features of healthcare organizations
regarding its capacity to provide quality care, for example, personnel, equipment, and policies

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(Lindly et al., 2017). These examples of structure quality measures are applied in nursing in
different ways. For example, personnel as an example of quality measure is applied in nursing by
ensuring standard staff-patient ratio. The staff-patient ration is used in nursing to mean the ratio
of nurses to that of patients in the hospital. The nursing patient-patient ratio determines is a key
determinant of quality care. A study by Carle Martsolf, & Scanlon (2017) stipulates that
currently, the standard nurse-patient ratio in a critical care unit is 1:2 which means that one nurse
is only allowed to care for two patients at maximum in the critical care. In the emergency
department, the nurse-patient ratio is 1:4 which means that one nurse is allowed to serve four
patients at maximum. All healthcare systems globally are required to adhere to standard nurse
patient-ratio. Adhering to the nurse-patient ratio ensures that nurses are allocating an adequate
number of patients (Lindly et al., 2017). This will allow them to give each patient adequate
attention and deliver care that meets the patient’s needs.
Another quality measure is a patient-reported outcome which measures the patient’s
experience of care based on the information that comes directly from the patients. A good
example of where the patient-reported outcome is applied in nursing in the contemporary world
is through the use of consumer assessment of healthcare providers. Through consumer
assessment of healthcare providers, patients are able to rate the performance of the nurses and
give recommendations where these nurses need to improve (Singh & Sittig, 2015). Based on the
patient experience, nurses can also understand how they can modify the existing measures of
care delivery to ensure that these measures will meet the needs of patients (Singh & Sittig, 2015).
This is important in nursing because it ensures that patients own the care delivery process since
they are actively involved in the process. Also, it will reduce the rate of admission since nurses
will be able to provide quality care that responds to the patient’s needs.

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3. Identify the quality and/or components needed to analyze a health care program's
outcomes.
One of the components that have been used to analyze the outcomes of healthcare projects is
Plan-Study-Act (PDSA) model. The main reason for the development of healthcare projects or
program is to make positive changes in healthcare processes (Lindly et al., 2017). Through
PDSA, the causal relationship between the changes in the introduced program and the outcomes
(Casalino et al., 2016). For example, the manner in which the program developed in healthcare
will meet its goals and objectives can be understood by relating the changes it introduces in the
healthcare organization and relating them to its outcome (Singh & Sittig, 2015). If the changes
introduced are related to the expected outcome of the program, then it means that the program
has met its set objectives. But if the changes are not related to the expected outcome, then it
means that the set goals of the project have not been met and modifications need to be done to
ensure that goals are met. A study by Carle Martsolf,, & Scanlon (2017) proposed three
questions that must be answered before using the PDSA cycles to analyze the program developed
in the organization. One of these questions is what is the main objective of the project? Another
question is how can people know that these objectives were reached? and the last question is
what are measures for reaching these goals? The PDSA cycle starts with the determination of the
nature of the scope of the problem and the changes that should be made before what should be
measured to understand the impact of change is outlined (Lindly et al., 2017). After this, change
is implemented as data and information are collected to help in the assessment of the results of
the program implemented.
Another component is the Toyota Production System. This system is mostly used in the
manufacturing of the Toyota cars and it has resulted in the lean production system where the

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customers’ needs are identified and activities that add no value are removed (Casalino et al.,
2016). This method seeks to investigate the errors in the existing projects and improve quality by
preventing similar errors in the next project. The principles of the Toyota Production system
have been used by both the technicians, physicians, and managers to increase the effectiveness of
patient care. According to the study by Chakraborty & Kaynak, (2018) healthcare organizations
have improved patient safety through Toyota Production methods which have enabled system
definition of the problem through the use of root-cause analysis and setting the goals that need to
be met. Also Beattie, et al (2015) has proposed that the Toyota Production System method has
cleared the following; the responsibility of each nurse and how each step will be carried out.
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Reference
Beattie, M., Murphy, D. J., Atherton, I., & Lauder, W. (2015). Instruments to measure patient
experience of healthcare quality in hospitals: a systematic review. Systematic
reviews, 4(1), 97.
Casalino, L. P., Gans, D., Weber, R., Cea, M., Tuchovsky, A., Bishop, T. F., ... & Evenson, T. B.
(2016). US physician practices spend more than $15.4 billion annually to report quality
measures. Health Affairs, 35(3), 401-406.
Chakraborty, S., & Kaynak, H. (2018). Towards a triadic quality measurement framework for
US Healthcare. Quality Management Journal, 25(1), 46-63.
Lindly, O. J., Geldhof, G. J., Acock, A. C., Sakuma, K. L. K., Zuckerman, K. E., & Thorburn, S.
(2017). Family-centered care measurement and associations with unmet health care need
among US children. Academic pediatrics, 17(6), 656-664.
Martsolf, G. R., Carle, A. C., & Scanlon, D. P. (2017). Creating unidimensional global measures
of physician practice quality based on health insurance claims data. Health services
research, 52(3), 1061-1078.
Singh, H., & Sittig, D. F. (2015). Advancing the science of measurement of diagnostic errors in
healthcare: the Safer Dx framework. BMJ quality & safety, 24(2), 103-110.