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Nursing Processes of Care and VA Inpatient Quality
Lynn M. Soban, RN PhD MPH
VA Greater Los Angeles Healthcare System, Sepulveda, CA
Funding Period: October 2007 - September 2012
Assuring patient safety in hospitals, and preventing the estimated million or more injuries that result from poor safety practices, is a top priority in our nation's health care system. Nurses and nursing processes for patient care are central to promoting patient safety in the hospital environment, yet have received comparatively little attention from patient safety researchers. Pressure ulcer (PrU) prevention is a critical patient safety concern for which delivery of recommended care processes are substantially, independently shaped by nursing leadership, nursing units, and the individual nurses within the units. Nationally accepted guidelines specify nursing care processes for PrU prevention (e.g., risk assessments), yet evidence indicates low rates of nurse adherence. While Quality Improvement (QI) efforts have reduced the overall incidence of PrU, an understanding of how these programs work and how they are influenced by organizational context (the local conditions within the setting in which care is delivered) has been absent. Such an understanding is needed to assure consistent delivery of PrU preventive care, and in turn, to assure consistently low rates of hospital-acquired pressure ulcers.
This Career Development Award sought to begin the development of an evidence-base for implementation of PrU preventive care by examining the role of organizational contextual features in delivery of this care.
A variety of methods were used including: a systematic review of the literature and meta-analytic techniques; qualitative data collection and analysis; and survey development.
Not yet available.
The work accomplished, underway, and recently funded during this Career Development Award represents an integrated body of research in an emerging area. Findings from this body of work will enable VA to move towards more consistent delivery of high quality PrU preventive care by: (1) informing the design and testing of intervention strategies to improve PrU preventive care in VA inpatient acute care settings; and (2) informing operational and policy decisions specific to PrU prevention activities nationally.
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DRA: Health Systems, Acute and Combat-Related Injury
MeSH Terms: none