The Journal of Perinatal & Neonatal Nursing (JPNN) has previously published issues on both quality and patient safety. This issue (29:2) adds another quarterly document on this topic for readers of JPNN. It seems that no other topic has pervaded the past decade of healthcare topics like quality and patient safety.
Also, within this issue, the editors have published an editorial on "predatory publishing." The International Academy of Nursing Editors (INANE) has encouraged all nursing editors to start the 2015 publishing year with an editorial on this topic. We encourage all readers to peruse this special editorial affecting the publishing world.
For JPNN 29:2, on Quality and Patient Safety, the Perinatal section presents 4 manuscripts. The first 2 are informational, focusing on the perinatal quality landscape and the other describing The Joint Commission and the Centers for Medicare & Medicaid Services' Pathway to Patient Safety and Quality. The additional 2 manuscripts are more clinical in focus. One comments on patient safety during induction of labor and the other describes an interprofessional education program to recognize and manage the compromised obstetric patient. The 2 perinatal columns, Expert Opinion and Legal Issues and Risk Management, present thoughtful commentary for all readers.
Howard and Jolles focus attention on the perinatal quality landscape, reviewing quality perinatal measures endorsed by the National Quality Forum. Fourteen perinatal quality measures are endorsed, and clinical parameters for each are reviewed. Mahlmeister presents a different focus by providing information on the Crosswalk, the alignment between The Joint Commission hospital standards and the Centers for Medicare & Medicaid Services' Conditions of Participation for Hospitals with Medicare. She describes the matrix of these 2 documents and the implications for clinical nurses.
Kriebs reviews patient safety issues surrounding the induction of labor. Patient safety can be improved when selected guidelines are utilized and best practices are followed during labor induction. Baird and Graves document the program called REACT, which involves collaborative educational goals to improve safety parameters for the compromised obstetric patient using improved skills sets, knowledge, and awareness.
Quality and safety are foundational to excellent healthcare delivery. Despite advances in neonatal technology and research, healthcare delivery systems remain complex, fragmented, varied, costly, and high-risk. Healthcare organizations are learning from other high-risk industries (eg, naval and aviation) as they journey toward creating highly reliable environments. This journey requires intentional planning that engages frontline staff and organizational executives to improve structures and processes.
The neonatal manuscripts for this volume all focus on quality and safety and provide evidence-based knowledge and tools to consider for both clinical and organizational applications. This issue will provide readers with the tools to develop a high-reliability safety culture to improve outcomes for all newborns and their families in the neonatal intensive care unit (NICU).
In "Following the Evidence: Enteral Tube Placement and Verification in Neonates and Young Children," Clifford and colleagues, provide a thorough review of the evidence and a practical clinical decision support algorithm to guide safe feeding tube placement and verification. The authors challenge nurses to reevaluate their practice and adopt a best practice strategy based on current evidence. This is the CE article for the neonatal section.
Grover and her colleagues, in "Interdisciplinary Teamwork and the Power of a Quality Improvement Collaborative in Tertiary Neonatal Intensive Care Units," review development of a national quality improvement collaborative infrastructure for neonatal patients with rare and complex medical conditions, using the IHI Breakthrough Series model. The collaborative demonstrates accelerated improvement using teamwork and key strategies to reduce practice variation and central line-associated bloodstream infection rates for high-risk patients.
The Bondurant and colleagues article, titled, "The Journey to High Reliability in the NICU," outlines the principles of a high reliability organization and the application of these principles for neonatal intensive care to achieve high reliability units. Their article describes the significant role neonatal nurses play at the point of care and outlines the importance of nurses taking action to incorporate a personal commitment to safety that includes leading innovation, interdisciplinary teamwork, and partnerships.
In "Human Factors in the NICU: A Bedside Nurse Perspective," Doerhoff and Garrison present a general overview of human factors commonly encountered by neonatal nurses and provide specific evidence-based strategies to reduce the potential for errors. This human factors engineering approach encourages collaboration between frontline staff and system leaders to identify potential problems that may lead to errors and solutions that can be hardwired into the environment to improve safe care delivery for both patients and clinicians.
-Diane Angelini, EdD, CNM, NEA-BC, FACNM, FAAN
Perinatal Editor
-Peggy Gordin, MS, RN, NEA-BC, FAAN
-Joan R. Smith, PhD, RN, NNP-BC
Neonatal Guest Editors