Journal of Nursing Care Quality

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January/March 2023 - Volume 38 - Issue 1

  • Staci Reynolds, PhD, RN, ACNS-BC, CPHQ
  • 1057-3631
  • 1550-5065
  • 4 issues / year
  • 1.728

Greetings!  In January 2023, I will transition into the Editor-in Chief position for the Journal of Nursing Care Quality.  I follow in the footsteps of Marilyn H. Oermann, PhD, RN, ANEF, FAAN who served in this role for over 20 years.  I want to thank Dr. Oermann for her wonderful leadership and expertise in publishing, which has allowed JNCQ to be the information leader in patient safety and quality care.  I am excited to begin this new chapter, as well as introduce a new focus for JNCQ on implementation science.  This issue contains a short editorial on implementation science, and how to incorporate these methodologies into quality-focused projects and studies.  I urge authors to provide detailed information on implementation science frameworks, methods, and strategies into their projects and publications.  Please also see the call for implementation science articles found on the JNCQ website.

In this issue: Carbapenem-Resistant Enterobacteriaceae (CRE) is an urgent health problem as it can negatively impact patient outcomes.  Authors implemented a robust hand hygiene quality improvement project to reduce health care associated-CRE, including real-time hand hygiene observations and strategies that mitigated local barriers.  Hand hygiene compliance increased from 49% to 76.9%, p=.0001, and the rate of health care associated-CRE decreased from 24.9% to 5.6%, p=.0001.  Researchers conducted a cross-sectional study to explore the relationship between workplace violence, burnout, patient safety, and workplace violence reporting.  Data were collected from 1781 nurses at a large medical center.  The authors found that workplace violence increased nurse burnout, which affected patient safety.

Staci S. Reynolds, Editor​

How Does Workplace Violence–Reporting Culture Affect Workplace Violence, Nurse Burnout, and Patient Safety?

Kim, Sinhye; Lynn, Mary R.; Baernholdt, Marianne; More

Journal of Nursing Care Quality. 38(1):11-18, January/March 2023.

How does workplace violence reporting culture affect workplace violence, nurse burnout, and patient safety?

Reducing Carbapenem-Resistant Enterobacteriaceae Using the Targeted Solution Tool: A Quality Improvement Project

Ragonese, Barbara; Mularoni, Alessandra; Valeri, Andrea; More

Journal of Nursing Care Quality. 38(1):47-54, January/March 2023.

Reducing Carbapenem-Resistant Enterobacteriaceae using the Targeted Solution Tool: A Quality Improvement Project

Demonstrating the Value of a Standardized Cognitive Assessment Tool Through the Use of Interprofessional Rapid Safety Rounds

Hayes, Mariah; Wheeling, Dianne; Kaul-Connolly, Sabine

Journal of Nursing Care Quality. 38(1):61-68, January/March 2023.

Demonstrating the Value of a Standardized Cognitive assessment Tool through the use of Interprofessional Rapid Safety Rounds

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Understanding patient’s cognitive functional status is critical to prevent adverse outcomes; however, there is variation in nurse’s proficiency in assessing patient’s cognitive status and screening tools often do not provide guidance on safety interventions to keep patients safe. A comprehensive 6-level Cognitive Pyramid, including guidance on safety interventions, was developed and used during interprofessional rapid safety rounds to assess patient’s cognitive status. The Cognitive Pyramid demonstrated appropriate face validity from 12 subject matter experts.  After implementing the pyramid during interdisciplinary rounds, the fall rate decreased to 0 falls per 1000 admissions. Read the full article ​after watching this video.​
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Poor leadership and teamwork in CPR are associated with poor patient outcomes. Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response. The Five-4-Life QI program was pilot tested in a pediatric unit within a 510- bed acute care hospital. Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program. Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses.  Read the full article after watching this video.
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There is limited evidence identifying best practices to promote competency of accurate assignment of the Emergency Severity Index (ESI) acuity level to patients who present to the emergency department (ED) triage. A retrospective chart review of 150 patients showed no statistically significant difference in mistriage rates from before and after triage trained nurses completed an ESI competency assessment.  Implementation of an ESI annual competency assessment aligns well with an emerging theme in the literature that ED nurses should be provided with ongoing education that reinforces knowledge and implementation of ESI triaging. Watch the video and read the article ​to learn more.
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Staff shortages, reduced budgets, and high acuity of violent psychiatric patients create challenges in psychiatric intensive care units. Staffing in our unit was based on patient census rather than evidence-based practices. A pre-/postintervention design was used to examine changes in nursing satisfaction and patient outcomes after implementing a psychiatric specific acuity tool. NDNQI survey results improved with the largest increase for the quality-of-care summary measure. An acuity tool can help standardize practice, determine fair patient assignments among staff, increase nurse satisfaction, and promote best practices for patient safety. Read the full article​ after watching this video.
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​Delirium is associated with increased hospital length of stay, discharge to skilled care, cost, morbidity, and mortality. At our organization, there was no formal delirium assessment performed by the nursing staff outside of the intensive care unit.  Staff nurse delirium education and a nurse-driven delirium screening protocol were implemented. No change in nursing knowledge occurred pre/post intervention. Falls, falls with injury, and restraint and sitter usage decreased. Changes in length of stay varied over the intervention period. The trend to discharge to home increased, while the trend to discharge to skilled nursing care decreased. Learn more about this initiative in the video and article​.













Watch our Videos on Writing Journal Articles on QI

This is the first video in our writing for publication series. The purpose of the manuscript and intended readers guide your selection of a journal for submission. Learn about directories of nursing and other journals and sending a query email.
This is the second video in our writing for publication series. Learn about the journal’s Information for Authors and why important, formats for writing different types of manuscripts, and reporting guidelines. The video will prepare you for writing papers about quality improvement and using the SQUIRE guidelines. References and tables/figures also are discussed.
​This is the final video in our writing for publication series. In this video you will get some additional tips on writing your manuscript and will learn about peer review and responding to reviewers’ comments. Other topics include authorship criteria, copyright, open access, and avoiding “predatory journals.”