Readiness of nurses for electronic networking for quality assessment and improvement.

Quality assessment and improvement (QAI) is a rapidly evolving component of health care. Its operationalization in clinical practice can be greatly enhanced by information sharing, best practice networking, and communication of experiences and resources. Nurses play a key role in both QAI and information sharing in this endeavor. Electronic communication supports the rapid sharing of QAI-related information across agencies to link nurses with a common interest in continuously improving the quality of health care delivery. It offers the opportunity to diminish the barrier of distance, which is especially relevant for nurses in rural areas. Before electronic communication was established as an information-sharing mechanism, however, the readiness of nurses in both rural and urban/suburban settings was assessed. A convenience sample of nurses in western New York, who were surveyed via written questionnaire regarding electronic communication, most often described their comfort in using this medium as uncertain. This finding supports the need for preliminary preparation focusing upon the skills and experience needed to utilize the computer as a communication medium.

In a changing world: database to keep the pace.

A database to manage health care information can be an especially useful tool for the CNS. Systematic management of information is important in the multifaceted role characteristic of the CNS's scope of practice. The CNS not only provides theoretically sound creative care to patients and serves as a role model to nursing staff, but also monitors and substantiates the quality and effectiveness of care delivered. To do this, the CNS participates in research activities and synthesizes and uses research findings. These aspects of professional practice require collection and analysis of information that could be facilitated by the use of a database. The purposes of this article are to introduce some basic concepts of database and its relevance and contribution to the CNS, discuss issues inherent in setting up a database, and provide guidelines for CNSs who are considering using a database in their clinical practice.

Staff development challenge: assuring nurses' competency in quality assessment and improvement.

Nursing administrators and nursing staff development educators face a challenge to insure that nursing staff are prepared to participate in quality assurance, assessment and improvement. This challenge is influenced by the evolving nature of quality assessment and improvement and the need to stay current in the field. This article suggests that staff development for quality assessment and assurance is a feasible approach to remedy the gap between the educational preparation and clinical practice expectations of nurses. Considerations to provide nurses with staff development offerings about quality assessment and improvement are discussed. Program topics are suggested.

Long-term care nurses identify educational needs regarding quality assessment and improvement.

An increasing demand is being placed on nurses who are practicing in long-term care settings to conduct and/or participate in quality assessment and improvement (QAI) activities. A local survey of directors of nursing in long-term care indicated both personal interest and interest on the part of their staff nurses to attend continuing education (CE) programs regarding quality of care to increase their competencies in this area. Specific interest areas and recommendations for an educational offering regarding quality assessment and improvement for long-term care nurses are described.

Evaluating quantitative research problems.

By focusing on criteria for evaluating quantitative research problems and by understanding their evolution from prior research and their placement within a theoretical context, nurses should realize that good research depends to a great degree on good questions. Unless an investigator has a "good, workable, significant topic, the most carefully and skillfully designed research project will be of no value.

Needs of nurse educators & clinical nurses regarding quality assurance education.

A study was done to determine the needs and educational interest regarding quality assurance of nurses practicing in both academic and clinical settings in Western New York. A written survey questionnaire was developed and distributed to a convenience sample. Responses were received from 98 nurse educators (47% of those contacted) and from 148 clinical area nurses (42% of those contacted). Concepts about quality assurance were itemized and respondents indicated their level of interest in obtaining further information to increase their QA competencies about each. The topics of interest to both groups were similar and included standards of care, legal issues, documentation, techniques for implementation of QA in clinical practice, and measures of quality of care. Characteristics about a continuing education offering that would be desirable were specified.

Enhancing subject recruitment for nursing research.

Nursing research most often requires human subjects. Consequently, an essential component in planning and conducting research entails recruitment of subjects who knowledgeably consent to participate. A well-established theoretical base exists regarding sampling techniques and procedures for research methods. The operationalization of the theory into practical terms may be of interest to the clinical nurse specialist (CNS) who frequently assumes a leadership role to both conduct nursing research in practice settings and to advise other nurses interested in conducting research. The recruitment efforts in four different nursing studies were compared and contrasted in an effort to determine effective and efficient approaches to this issue. Sample populations included nurse practitioners, patients, nurse aides, and nurse educators. Methods of recruitment included direct contact, mail, and telephone contact. While the settings, purposes, and designs of the studies varied, some common elements regarding subject recruitment were suggested. The recruitment methods have been described, along with the implication in terms of practical application for conduct of nursing research by CNSs.

Increasing productivity by developing alliances.

Collaborative alliances among nurses may provide a feasible and satisfying opportunity to increase the productivity of nurses. Inherent in successful alliances are the development of trust, compatibility, commitment, and mutality of benefits. The development of collaborative relationships among clinical research nurses, a research methodologist, and a nurse educator resulted in several federally funded grants and publications. The alliances described here cross disciplines and institutions and demonstrate the enhanced productivity that can result from such efforts.