Editor-in-Chief: Marilyn H. Oermann, PhD, RN, FAAN
ISSN: 1057-3631
Online ISSN: 1550-5065
Frequency: 4 issues / year
Ranking: Nursing 24/110
Impact Factor: 1.389
About Journal of Nursing Care Quality

JNCQ provides practicing nurses, nurses in leadership roles, and other health care professionals with new information and research on patient safety, quality care, evidence-based practice, and more. Sign up for alerts to our Published Ahead-of-Print articles.

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• Fast turnaround time for reviews: Average 4 weeks from submission.
• Fast publication time: Average 4 weeks from acceptance to online publication.
• Read by nurses, QI professionals, and others worldwide.
• JNCQ has a 2014 impact factor of 1.389.   

About This Issue

In this issue, Richard Ricciardi, Healthcare Scientist in the Center for Evidence and Practice Improvement at AHRQ, discusses patient safety in ambulatory environments and the important role of nursing. In another article, Clark and colleagues describe their project to improve the pneumococcal immunization rate within their health system. Using the presurgical testing center, they increased the rate from 24% to 54%:  the authors share their processes and tools. In a small community hospital, nurses developed an At Risk Care Plan to anticipate safety and care needs of patients at risk and communicate those needs to the health care team. This innovative intervention dramatically reduced hospital readmissions, costs, and adverse events for high risk adult inpatients. Prevention of medication errors continues to be a need. Simsic and colleagues describe the outcomes of their QI project that reduced medication errors. They implemented a multidisciplinary ICU quality committee, nursing education, shift change medication double checks, medication error huddles, a safety systems checklist, a distraction-free zone to enter orders, and medication bar coding. Becker started a bag medication reconciliation process in the hospital setting to decrease medication discrepancies at post hospitalization follow up. Patients received a green medication bag on discharge and were taught to bring the bag with all of their medications to their first follow-up appointment. This strategy worked well and is easily implemented elsewhere. Other articles in this issue describe improving delivery of primary care preventative services using Six Sigma methods, a systems redesign to improve dysphagia screening, a new volunteer service to enhance patients’ experiences, best practices for care transitions and for implementing QI interventions, the quality of hospice care, and a QI study to reduce resident pain in nursing homes. Tzeng et al. report on their innovative fall prevention intervention, iEngaging, which involves patients in their own fall prevention during hospital stays. Migration of patients toward the foot of the bed in ICUs may cause shear and friction between the patient and mattress, reduce elevation of the patient's torso, and require frequent repositioning:  take time to read the article by Davis and Kotowski. It is open access so everyone can read and learn from it. 

Marilyn H. Oermann, PhD, RN, ANEF, FAAN

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Preventable adverse patient outcomes and hospital characteristics in rural versus non rural US hospitals under the new Centers for Medicare & Medicaid Services reimbursement policy were examined using the American Hospital Association Annual Survey and Hospital Compare data. Under the new policy, rural hospitals tended to have fewer hospital-acquired conditions than non rural hospitals except for patient falls. Case mix was consistently related to falls after controlling for hospital characteristics.Read the article here.

This quality improvement project was designed to implement a sit-to-stand exercise program delivered by nursing assistants in an assisted living facility. The findings have implications for the role that nursing assistants can play in promoting exercise and thus preventing avoidable decline in institutionalized residents and also for implementing QI in these settings. Read the article here.

The authors improved dysphagia-screening processes in a tertiary Veterans Affairs Medical Center. The dysphagia-screening tool was redesigned on the basis of frontline clinician feedback, clinical guidelines, user satisfaction, and multidisciplinary expertise. The revised tool triggered a speech-language consult for positive screens and demonstrated higher scores in user satisfaction and task efficiency. Systems redesign processes were effective for redesigning the tool and implementing practice changes with clinicians involved in dysphagia screening. Read the article here.

  Registered nurse (RN) “second victims” are RNs who are harmed from their involvement in medical errors. This study found a relationship between RN involvement in preventable adverse events and 2 domains of burnout: emotional exhaustion (P = .009) and depersonalization (P = .030). Support to RNs involved in preventable adverse events was inversely related to RN emotional exhaustion (P < .001) and depersonalization (P = .003) and positively related to personal accomplishment (P = .002). Read the article here.
  Medication discrepancies occur in 70% of hospital patients, especially during discharge. The author initiated a bag medication reconciliation process in the hospital to decrease medication discrepancies by encouraging evaluation of medication adherence, side effects, and monitoring at posthospitalization follow-up. After implementation, a 7% decrease in reportable errors was noted. Read the article here.