In the commentary from the Agency for Healthcare Research and Quality, Dr Jeffrey Brady discusses 2 recently published National Healthcare Quality and Disparities Report chartbooks, which will be of interest to readers. These chartbooks call specific attention to the quality of care given to—and disparities suffered by—Blacks and Hispanics. The chartbooks will be useful to nurses and other health providers to gain a better understanding of how their patient populations compare to national norms and for improving quality of care. In another national report, Alexander et al describe their model for assessing trends in nursing home information technology adoption and quality measures. In the article by Jacobson and colleagues, you will learn about their QI project to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed. The documentation reports provided feedback to nurses and triggered reminders and re-education. Those reports improved the documentation of pressure ulcer prevention interventions and decreased the number of hospital-acquired pressure ulcers. Did you realize that among hospitalized patients, malnutrition is prevalent yet often overlooked? In this issue authors report on the outcomes of a health system QI program to integrate early nutritional care into the nursing workflow. Nurses screened for malnutrition risk at patient admission and then immediately ordered oral nutritional supplements for those patients. The program reduced pressure ulcer incidence, length of stay, 30-day readmissions, and costs. This is an open-access article, free to all readers. In another QI initiative in a pediatric, tertiary care hospital, nurses used teach-back combined with a discharge bundle across 16 inpatient units. The intervention resulted in an 8% reduction in 7-day readmission and 10% reduction in 30-day readmission over 16 months. Many agencies struggle with ensuring optimal care coordination during transitions: Radwin et al present an expanded theoretical framework for care coordination. Two studies on handoffs are reported in this issue. In one study the authors examined 27 mnemonics to identify what information should be communicated during a handoff. In the other study from Australia, Johnson et al evaluated the outcomes of using an integrated nursing handover system (structured content and an electronic tool within the patient clinical information system with bedside delivery). There were improvements in the transfer of critical patient information and reductions in clinical management incidents. Read this issue from front to back to learn more about these QI studies and gain other ideas you can use in your own settings.
Marilyn H. Oermann, PhD, RN, ANEF, FAAN