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The Slippery Slope: Differentiating Between Quality Improvement and Research

Newhouse, Robin P. PhD, RN, CNA, CNOR; Pettit, Joan C. JD, MA, CIP; Poe, Stephanie MScN, RN; Rocco, Laura RN, MS

Journal of Nursing Administration: April 2006 - Volume 36 - Issue 4 - p 211-219

As hospitals strive to create strong work environments for nurses, many use the core requirements for Magnet designation to enhance and build new programs in research and evidence-based practice into patient care and operational processes. The problem is the use of quality improvement projects in these efforts as evidence of a healthy "research" program. This confusion can lead to 3 major consequences: (1) poorly designed and interpreted studies; (2) lack of consideration of subject rights; and (3) Institutional Review Board or other regulatory sanctions for noncompliance with federal, state, and local law and institutional policies. The purpose of this article is to differentiate between research and quality improvement, explore the potential risks of confusing quality improvement with research, and suggest criteria by which to determine the difference.

Authors' affiliations: Nurse Researcher (Dr Newhouse); Assistant Director of Nursing, Clinical Quality (Ms Poe), Nursing Administration, The Johns Hopkins Hospital; Assistant Professor (Dr Newhouse), The Johns Hopkins University School of Nursing; Chair (Ms Rocco), Johns Hopkins Medicine IRB X; Human Subject Regulatory Affairs Specialist (Ms Pettit); Co-chair IRB-X (Dr Newhouse), Office of Human Subject Research, Johns Hopkins University School of Medicine, Baltimore, Md.

Corresponding author: Dr Newhouse, The Johns Hopkins Hospital, 600 North Wolfe Street, Billings 220, Baltimore, MD 21287-1720 (

© 2006 Lippincott Williams & Wilkins, Inc.