Assignment : Tools for Measuring Quality

Quality measurement is important in nursing practice owing to the fact that it helps ensure successful assessment and hence delivery of quality health services. In the absence of quality measurement, there would be no way of finding out whether patients have access to meaningful and competent services. Essentially, information that is derived from quality measurements is used to determine what is appropriate in practice as well as what is not appropriate. Quality measures use various tools to quantify various aspects in the delivery of healthcare services. Towards this end, it would be prudent to note that there are various quality measurements that can be used in nursing practice. There are largely dependent upon certain aspects of healthcare which could be inclusive of, but they are not limited to; population and public health, patients perceptions in their care, patient engagement in their own care, care coordination, efficient use of healthcare services, patient safety, clinical processes, and patient outcomes. For the purposes of this assignment, I will focus on three rate-based measurements that relate to patient outcomes in healthcare settings. In particular, I will focus on smoking cessation for pneumonia risk reduction, restraints prevalence, and falls with injury measures.

Description of Measures

With regard to smoking cessation for pneumonia risk reduction as a measure to improve outcomes of care among patients, it would be prudent to note that worsening of outcomes among various pneumonia cases is associated with tobacco or cigarette smoking. During the annual measurement period in a control study that was population based, the risk of invasive pneumococcal disease among ex-smokers and those who have never smoked in the past 13 years was reduced by 14 out of 100 after smoking cessation was included (Baskaran et al., 2019). With regard to restraints prevalence, restraints prevalence measure was used as a measure to determine the level of knowledge as well as awareness on use of restraints among residents in nursing homes during the entire measurement period (Schnelle et al., 2004). Falls with injuries measure was used to determine the risk of falling among residents living in nursing homes (Hestekin et al., 2013). The main reason as to why I chose to focus on the said rate-based measurement is owing to the fact that it relates to the quality of services and clinical practices among nurses that relate to how patients are cared for, and their experiences regarding the said care. Essentially, the said indicators can be used to measure the quality of services that patients receive in healthcare facilities by adjusting other risk factors. For instance, smoking cessation for pneumonia risk reduction measure can be used to determine the likelihood of developing community acquired pneumonia when patients smoke or are exposed to smoke (Baskaran et al., 2019). Information gathered on this front would then be used to create or improve smoking cessation programs so as to reduce the said risks. With regard to the restraint prevalence measure, it is worthwhile noting that data on the prevalence of restraints in nursing homes will provide crucial information on settings that do not make use of restraints. This would provide an opportunity for knowledge dissemination, i.e. with regard to education or instruction on the importance/relevance of using restraints. On the other hand, information relating to falls with injuries measure would also be used to determine the prevalence and incidence of falls that are related to injuries in healthcare facilities. As a result, quality improvement measures would be put in place so as to reduce falls in the said facilities.

Definition of Measures

Smoking cessation measure is aimed at dealing with problems related to smoking. This is more so the case given that smoking has been associated with various health problems and concerns such as increased risk of community acquired pneumonia (Baskaran et al, 2019). For instance, the effect of smoking on patients with pneumonia was identified through a meta-analysis study that was conducted to gauge the role that cigarette smoking plays in as far as the development of community acquired pneumonia among adults is concerned (Baskaran et al., 2019). It would be prudent to note that as the authors further indicate, undoubtedly, quitting smoking is among the most important steps smokers can take to lower the risk of respiratory infections and pneumonia (81). Essentially, the study focused on smokers and ex-smokers who are aged between 18 years and 64 years of age. However, I am of the opinion that adults who are aged above 65 years ought to have also been included in the said analysis owing to the fact that that they are also at a risk of developing community acquired pneumonia. This is more so the case given that the said adults are in most cases passive smokers or are exposed to second hand smoke (Baskaran et al., 2019). The meta-analyses showed that adults who currently smoke are at the highest risk of developing community acquired pneumonia. Essentially, their likelihood of developing the said infection was found to be 53% more than for those who were ex-smokers. In addition, the said smokers possessed more than two times the risk of developing community acquired pneumonia in comparison to that those who had never smoked. The likelihood of developing CAP among ex-smokers was found to be approximately 49% higher than those who had never smoked (Baskaran et al., 2019). In a similar study, it was found that older adults were at a higher risk of developing community acquired pneumonia (Campagna, Amaradio, Sands, and Polosa, 2016, p. 132).

Reduction in restraint use in healthcare facilities has been associated to lack of adequate knowledge in the use of restraints and related care processes (Schnelle et al., 2004). The said concern largely relates to residents in nursing homes. To determine the prevalence of restraints, the authors utilized a cross-sectional study roping in 413 residents from fourteen nursing homes (Schnelle et al., 2004). Falls with injury cases are associated with high death rates and disabilities. Falls with injuries are caused by various risk factors which are inclusive of, but they are not limited to; severe or extreme sleep problems, grip strength,...…age factor can be adjusted for other factors by higher mortality related to falls in older adults and declining memory in the said adults (Campagna, Amaradio, Sands, and Polosa, 2016). When other factors are adjusted in this case, results show an increased risk of falls in adults who are 60 years and above.

Goal Setting Strategies

The goals that should be set in any given organization that wishes to excel in the healthcare realm, with specific reference to the three risk measures highlighted in this text, should be SMART. This is to say that it should not only be Specific and Measurable, but also Achievable, Realistic, as well as Timely. For instance, in smoking cessation for pneumonia, an organization can set a goal such as; to reduce the risk of community acquired pneumonia among adults aged 15 years and above through smoking cessation programs within a period of two years. In as far as restraints prevalence is concerned, an organization can set a goal that is essentially aimed at reducing the prevalence of restraints in nursing homes by increasing residents knowledge on restraint use through education practices over a period of 6 months. It should also be noted that when it comes to setting SMART goals on falls with injury measure, an organization can come up with a goal of reducing the number of deaths associated with falls with injury risk among adults aged 50 years and above by embracing the relevant evidence-based practices and systems.

Importance of Rate-Based Measures for Clinical Organization

Smoking tobacco increases the risk of developing community acquired pneumonia. According to Baskaran et al. (2019), cigarette smoking leads to impairment of the

mocociliary clearance whereby it increases the rate at which mucous is produced while reducing ciliary beat frequency which are associated with pneumonia. It therefore follows that smoking cessation will significantly improve the outcomes among individuals who are at risk of developing pneumonia in a healthcare setting such as an outpatient clinic. For instance, according to Cecere et al. (2012), smoking increases the rate at which affected individuals are hospitalized. Therefore, when a smoking cessation measure is properly implemented, outcomes are likely to be significantly enhanced. As a result, the rate of hospitalization linked to pneumonia cases would largely reduce.

Restraint use measure will also have a huge impact in the acute care hospital settings. According to Schnelle et al. (2004), using restraining devices and the deployment of related measures improves the quality of care. For instance, use of restrains would improve patient care in acute care setting by addressing concerns around as delirium and other mental ability disturbances that could be considered significant risk factors (Thomann et al., 2020). The authors in this case further suggest that there is need to raise awareness among the inter-professional care team. On the other hand, quality measures on falls with injury will also have a significant impact in hospital settings. According to Slade et al. (2017), falls with injuries are associated with high costs (financial or otherwise) in hospitals. The relevant quality measures would significantly reduce the number of injuries and/or…