QUERI – Quality Enhancement Research Initiative

VA Nursing Innovations Collaborative for Evaluation

Tampa, FL

Overview:

The mission of VHA Nursing Innovations Collaborative for Evaluation (NICE), located at the James A. Haley Veterans' Hospital in Tampa, FL, is to provide the Office of Nursing Service (ONS) with services for evaluating structures and processes of implementation and outcomes of VHA nursing strategic initiatives.

Objectives:

Project 1. The goal of this project was to evaluate national implementation of the VHA Handbook 1180.02 for the Prevention of Pressure Ulcers (PrU). Specifically, investigators evaluated clinical and documentation practices that either positively or negatively affected skin-risk indicator data as identified in VA Nursing Outcomes Database (VANOD) reports. Specific aims using VANOD data and focus groups were to:

• Evaluate the completeness and variability of five skin-risk indicators;
• Identify barriers and facilitators to ensuring validity of data; and
• Identify barriers and facilitators to facility processes of conducting, validating, and documenting daily comprehensive skin assessments.

Project 2. To respond to the national calls for more doctorally prepared nurses to meet the challenges of healthcare in the 21st century, VA is evaluating its nursing workforce to identify ways to best support the attainment of doctoral degrees to advanced practice, nursing research, and evidence-based practice, and improve quality, safety and patient outcomes. The goal of this evaluation is to use multiple methods to determine the size and scope of the VA doctoral nursing workforce. Specific aims are to:

• Determine the number, location, titles, roles, and responsibilities of nurses with doctoral degrees in the VHA; and
• Compare the success rate of each strategy for identifying doctoral nurses in the system.

This descriptive quality improvement project will use survey methods, and doctorally-prepared nurses will be identified using five different strategies (e.g., emailed surveys). Descriptive and comparative statistics will be used to summarize data.

Operations Partner:

The key operational partner is the Office of Nursing Services (ONS), whose mission is toprovide "leadership, guidance and strategic direction on all issues related to nursing practice and nursing workforce for clinical programs across the continuum of care and across the spectrum of care delivery sites that impact our veterans."

Principal Investigator: Gail Powell-Cope, PhD; contact at Gail.Powell-Cope@va.gov.