In what areas have you seen improvement? What areas still present challenges?

Discussion 6.1 and 6.2
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Improving Quality

Improving the quality of health care delivery and patient safety continues to be a political concern and has been at the heart of reform issues for many years. The American Nurses Association (ANA) and the Institute of Medicine (IOM) have increased awareness of health care quality and safety issues, as well as advocated for health care reform. The documents featured at the ANA and IOM websites listed in this week?s Learning Resources focus on many of the current issues surrounding quality and safety in the health care industry.

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To prepare:

Review this week?s Learning Resources, focusing on the Six Aims for Improvement presented in the landmark report ?Crossing the Quality Chasm: The IOM Health Care Quality Initiative.?
Consider these six aims with regard to your current organization, or one with which you are familiar. In what areas have you seen improvement? What areas still present challenges? As a nurse leader, how can you contribute to improving the organization?s achievement of these aims?
Select one specific quality or safety issue that is presenting a challenge in the organization. Consider at least one quality improvement strategy that could be used to address the issue, as well as which of the six aims for improvement would then be addressed.
Reflect on your professional practice and your experiences with inter-professional collaboration to improve quality and safety. How has inter-professional collaboration contributed to your organization?s efforts to realize the IOM?s six aims for improving health care? Where has inter-professional collaboration been lacking?

Post a description of the quality or safety issue you selected and a brief summary of the impact that this issue has on health care delivery. Describe at least one quality improvement strategy used to address this issue. Then explain which of the six ?aims for improvement? are addressed by the strategy. Finally, explain how inter-professional collaboration helps improve quality in this area.

Discussion 6.2

Critical Thinking

Recall your early clinical nursing experiences?what guided your decisions? Did you practice nursing ?by the book?? Now, consider how you make decisions today. How have your clinical experiences fostered a greater depth of knowledge and critical thinking?

This week?s Learning Resources explore skill development and levels of knowledge acquisition based on clinical experience. For example, Benner suggests that as a nurse gains more experience, knowledge and skill level increases. Nurses move from novices?making decisions based on rules?to experts who are able to see connections between actions and outcomes using critical thinking. This Discussion focuses on the role of critical thinking in nursing practice and the connection between critical thinking, clinical competence, and scholarship.

To prepare:

Review the Learning Resources focusing on critical thinking and Benner?s interpretation of the Novice to Expert theory.
Reflect on how critical thinking is used in clinical practice. How does critical thinking relate to, or support, clinical competence?
What critical thinking strategies do you use to improve your clinical competence and thus move from novice to expert?
Consider the connection between critical thinking, nursing practice, and scholarship.


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