Quality and Safety in Nursing Science: Evidence-Based Practice
This paper examines the roles of quality and safety in nursing science, drawing on contemporary research to trace how evidence-based measures are cultivated, implemented, and assessed. The discussion covers person-centered care and its association with higher quality outcomes, the relationship between nurse staffing and patient mortality, the problem of unfinished nursing care, and the theory-practice gap faced by new graduate nurses. A contemporary study on patient participation in care serves as a real-world illustration of how theoretical frameworks translate into practical outcomes. The paper also addresses administrative data as a tool for measuring nursing-sensitive indicators and concludes with a reflection on how these interconnected elements support positive patient health outcomes.
- Introduction: Overview of quality and safety in nursing science
- Quality Measures in Nursing Science: Research linking person-centered care to patient outcomes
- Safety Measures in Nursing Science: Training gaps and patient involvement in safety
- Contemporary Example: Patient-Centered Care: Study on patient participation categories and findings
- Assessment of Program Outcomes: Administrative data measuring nursing-sensitive indicators
- Discussion and Conclusion: Nurse self-assessment and synthesis of evidence-based practice
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What makes this paper effective
- Grounds each claim in peer-reviewed nursing research, citing multiple studies with specific statistics (e.g., "23% lower odds of 30-day inpatient mortality") that lend concrete credibility.
- Moves logically from broad concepts (quality, safety) to a focused contemporary example (patient participation study), demonstrating how theory connects to real-world practice.
- Maintains a consistent thematic thread — the interdependence of quality and safety — across all sections, reinforcing the paper's central argument.
Key academic technique demonstrated
The paper effectively uses synthesis across multiple studies rather than summarizing each source in isolation. By drawing connections between person-centered climate, unfinished care, graduate nurse transitions, and administrative outcome data, the author shows how disparate findings collectively build a coherent argument about nursing quality and safety standards.
Structure breakdown
The paper opens with a framing introduction, then dedicates separate sections to quality measures and safety measures before pivoting to a contemporary study as an applied example. A methods-adjacent section addresses program outcome assessment, followed by a brief discussion of professional self-assessment and a conclusion that synthesizes the evidence-based practice cycle from cultivation through assessment. The structure mirrors the nursing quality improvement process it describes.
Introduction
Quality and safety are paramount for patients experiencing illness and seeking treatment. The role of the nurse is complex, requiring effectiveness, efficiency, compassion, and understanding. Some aspects of nursing science involve research and the use of evidence-based practice to provide the high quality and safety standards patients deserve. How are quality and safety measures adopted and implemented? This essay examines the role quality and safety play in nursing science using a contemporary example, and considers how real-world strategies aim to test and assess standards of care in order to deliver the positive health outcomes patients need. By delving into the real-world application of quality and safety measures, one can trace the process from the cultivation of concepts through implementation and assessment.
Quality Measures in Nursing Science
One effective way to understand whether a patient is experiencing a high quality of care is through patient outcomes and patient opinions about their treatment experience. One study examined the effects of a more person-centered approach to quality of care and found a strong association with higher quality ratings. "The relatives' experiences of a more person-centered climate were associated with higher ratings of the quality of care. A person-centered climate of safety had the strongest unique association with the quality of care" (Lood et al., 2019, p. 1). Such results advance the understanding of the correlation between quality of care and person-centeredness in nursing homes. The positive health outcomes as perceived by relatives demonstrated that person-centered climate facets — hospitality and safety — play a major role in quality of care. This suggests that focusing on a holistic approach to the patient can serve to improve patient outcomes and, consequently, quality of care.
Quality of care and safety often go hand in hand. High quality of care can be reflected in lower mortality rates. "Patients cared for in hospitals where a high proportion of RNs reported excellent quality of care (the highest third of hospitals) had 23% lower odds of 30-day inpatient mortality" (Smeds-Alenius, Tishelman, Lindqvist, Runesdotter, & McHugh, 2016, p. 117). Nurses who ensure patients take their medications, advise them on post-hospital routines, and educate them on lifestyle changes can contribute to improved mortality rates. Higher quality of care often means committing to a comprehensive and effective protocol that gives patients a genuine chance to improve their health outcomes.
When nurses engage in problematic practices such as unfinished care, it can lead to negative health outcomes, reinforcing the correlation between quality of care and safety. "Unfinished care is a significant problem in acute care hospitals internationally. Prioritization strategies of nurses leave patients vulnerable to unmet educational, emotional, and psychological needs" (Jones, Hamilton, & Murry, 2015, p. 1121). For example, if nurses fail to check patient charts and administer the wrong medication, this can cause adverse health problems or even death. Even routine periodic checks — such as monitoring whether patients have fallen — are part of quality of care and may be forgotten or neglected. Overall, it is important to recognize that high quality of care directly supports high levels of safety for patients.
Safety Measures in Nursing Science
Knowledge of safety practices comes from research and training. When nursing graduates enter the workforce, they may be unaware of the various patient safety considerations they will encounter. "A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners" (Murray, Sundin, & Cope, 2017, p. 31). That transitional period from student to registered nurse can be difficult due to the demands of acquiring new skills and applying theoretical knowledge in practice. Effective training and communication from administration and experienced nurses could translate into a better learning experience and, ultimately, stronger patient safety strategies. Identifying the gap in inexperience regarding safety measures helps clarify why gaps in safety persist.
A key gap is the lack of patient involvement in safety, whether due to limited patient awareness or inadequate follow-through by nurses and physicians. Patient safety specialists have identified patients as having a vital role in promoting their own safety. Although organizations generally considered their level of patient safety "acceptable," patient participation in their own safety varied and was often misaligned with national standards. "Management of patient safety incidents differed between organizations. Experts also suggested that patient safety training should be increased in both basic and continuing education programs for healthcare professionals" (Sahlström, Partanen, Rathert, & Turunen, 2016, p. 461). When patients are not knowledgeable about steps they can take to keep themselves safe, this can be a key indicator of inadequate safety promotion within an organization. Safety is critically important to patient health outcomes, as its absence contributes to increased rates of mortality, infection, and complications.
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