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Differentiate between quality improvement projects and quality improvement research. How can you use quality improvement in your scholarly project. My project is based on the PICOT question below. Please table this response using the PICOT. 

Please use ONLY the articles attached and NO other resources. Please make sure that you provide in-text citation for all references.

I need this in 600 words  with references and in-text citations. .


For nurses in Home Health experiencing burnout, does the introduction and usage of a mindfulness-based program versus no intervention at all during a 12-hour shift, reduce their burnout within 6 months?

Quality improvement in nursing: Administrative mandate or
professional responsibility?

Shigeko Izumi, PhD, RN
Assistant Professor, College of Nursing, Washington State University, Spokane, Washington USA

For professionals, providing quality service and striving for excellence are ethical responsibilities.
In many hospitals in the U.S., however, there is evidence indicating current quality improvement
(QI) involving nurses is not always driven by their professional accountability and professional
values. QI has become more an administrative mandate than an ethical standard for nurses. In this
paper, the tension between QI as nurses’ professional ethics and an administrative mandate will be
described, and the implicit ideal-reality gap of QI will be examined. The threat to professional
nursing posed by the current approach to QI will be examined, and ways to incorporate nursing
professional values in a practical QI effort will be explored.

nursing care; quality improvement; quality of healthcare; professional ethics

With growing concern about hospital care quality and attention to the need for improvement
of care, quality improvement (QI) has become an administrative mandate in U.S. hospitals.
Although it is encouraging to see the shift of attention from cost containment alone to
improvement of quality, the current approach to QI has the potential to undermine the
professional values of nursing. In this paper, an implicit gap between QI as ideal nurses’
professional accountability and the reality of current QI activities will be described. Further,
this paper will examine potential threats the current QI approach poses to professional
nursing, and explore possibilities for integrating nursing professional values in QI efforts.

Current Approaches to Quality Improvement
There are three interrelated but slightly different views about the cause of the healthcare
quality problem: 1) Inefficient healthcare system, 2) lack of systematic quality evaluation,
and 3) insufficient staffing. Each perceived cause leads to a different approach to improve
quality of care (see table 1).

Inefficient System as a Cause of Quality Problem
From the late 1990s, the quality of healthcare has been a growing concern for many
Americans and various reports made it clear that Americans were not receiving the quality

Corresponding author: Shigeko Izumi, Washington State University College of Nursing, P.O. Box 1495, Spokane, WA 99210-1495,
([email protected]).

Early work of this manuscript was presented at International Centre for Nursing Ethics Conference 07/18/2008 at Yale University,
New Heven, Connecticut, USA.

NIH Public Access
Author Manuscript
Nurs Forum. Author manuscript; available in PMC 2013 October 01.

300 | Health Expectations. 2018;21:300–307.wileyonlinelibrary.com/journal/hex

Accepted: 21 July 2017

DOI: 10.1111/hex.12615


Patient- centred care is a way of doing things: How healthcare
employees conceptualize patient- centred care

Gemmae M. Fix PhD1,2,3 | Carol VanDeusen Lukas EdD1,2,3 | Rendelle E. Bolton MPH
MSW, MA1,3 | Jennifer N. Hill MA4 | Nora Mueller MAA1,3 | Sherri L. LaVela PhD, MPH,
MBA4,5 | Barbara G. Bokhour PhD1,2,3

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,
provided the original work is properly cited.
© 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd

1Center for Healthcare Organization and
Implementation Research (CHOIR), VA Health
Services Research and Development Service,
Bedford, MA, USA
2Boston University School of Public Health,
Boston, MA, USA
3Evaluating Patient-Centered Care, Bedford,
4Center for Evaluation of Practices and
Experiences of Patient-Centered Care, Hines,
5Center for Healthcare Studies, Institute for
Public Health and Medicine, General Internal
Medicine and Geriatrics, Feinberg School of
Medicine, Northwestern University, Chicago,

Gemmae M. Fix, Center for Healthcare
Organization and Implementation Research
(CHOIR), ENRM Veterans Hospital, Bedford,
Email: [email protected]

Funding information
This study was funded by the Department
of Veterans Affairs, Veterans Health
Administration, Office of Research and
Development, Health Services Research
and Development, Quality Enhancement
Research Initiative QUERI & Office of Patient
Centered Care and Cultural Transformation
(PEC 13- 001). Dr. Fix is a VA HSR&D Career
Development awardee at the Bedford VA
(CDA 14- 156). The views expressed in this
article are those of the authors and do not
necessarily reflect the position or policy of the
Department of Veterans Affairs or the United
States government.

Background: Patient- centred care is now ubiquitous in health services research, and
healthcare systems are moving ahead with patient- centred care implementation. Yet,
little is known about how healthcare employees, charged with implementing patient-
centred care, conceptualize what they are implementing.
Objective: To examine how hospital employees conceptualize patient- centred care.
Research Design: We conducted qualitative interviews about patient- centred care
during site four visits, from January to April 2013.
Subjects: We interviewed 107 employees, including leadership, middle managers,
front line providers and staff at four US Veteran Heal


Scholarly work products of the doctor of nursing practice: one

approach to evaluating scholarship, rigour, impact and quality

Mary F Terhaar and Martha Sylvia

Aims and objectives. The aim of this investigation was to evaluate, monitor and

manage the quality of projects conducted and work produced as evidence of

scholarship upon completion of Doctor of Nursing Practice education.

Background. The Doctor of Nursing Practice is a relatively new degree which

prepares nurses for high impact careers in diverse practice settings around the

globe. Considerable variation characterises curricula across schools preparing

Doctors of Nursing Practice. Accreditation assures curricula are focused on

attainment of the Doctor of Nursing Practice essentials, yet outcomes have not

been reported to help educators engage in programme improvement. This work

has implications for nursing globally because translating strong evidence into

practice is key to improving outcomes in direct care, leadership, management and

education. The Doctor of Nursing Practice student learns to accomplish transla-

tion through the conduct of projects. Evaluating the rigour and results of these

projects is essential to improving the quality, safety and efficacy of translation,

improvements in care and overall system performance.

Design. A descriptive study was conducted to evaluate the scholarly products of Doc-

tor of Nursing Practice education in one programme across four graduating classes.

Methods. A total of 80 projects, conducted across the USA and around the globe,

are described using a modification of the Uncertainty, Pace, Complexity Model.

Results. The per cent of students considered to have produced high quality work

in relation to target expectations as well as the per cent that conducted means

testing increased over the four study years.

Conclusions. Evaluation of scope, complexity and rigour of scholarly work products

has driven improvements in the curriculum and informed the work of faculty and


Relevance to clinical practice. Methods, evaluation and outcomes conformed

around a set of expectations for scholarship and rigour have resulted in measur-

able outcomes, and quality publications have increased over time.

Key words: clinical nursing, Doctor of Nursing Practice, education, evaluation,

outcomes, projects, scholarship

What does this paper contribute

to the wider global clinical


? Well-designed, well-executed
translation projects based on
findings of strong research can
effectively introduce evidence
and innovation into practice
across diverse settings, commu-
nities and countries because
these projects

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