The value of a quality improvement initiative is very important as we strive to improve the health of our nation and world. Increasingly, quality improvement projects are being led by nurses often in collaboration with other healthcare professionals. These projects take place in many settings including the hospital, ambulatory surgery centers, clinics, community health agencies, skilled nursing facilities, educational institutions, and more. Often the problem is identified by nurses who then work to solve the problem.
In 1999, the Agency for Healthcare Research and Quality (AHRQ) was developed. During the more than two decades in existence, the work that has been achieved under the direction of AHRQ cannot be denied. On a quick review of the AHRQ website, one can find multiple resources for improving nursing care (AHRQ, 2021). There are many organizations that exist today whose mission is to improve healthcare quality (American Nurses Association, 2021). The American Nurses Association has been involved in improving patient safety by advocating for quality improvement in nursing care for more than a century.
Nurses have been involved in quality improvement since it was introduced by Florence Nightingale. Most all of us can remember what their first experience was with quality improvement. My first experience was with a halo-pelvic pin care improvement project. It was not nearly as organized as the projects that are done today, but it did have the intended impact of improving the care of patients with severe scoliosis who required that traction device.
Quality improvement projects have been supported by organizational leadership. In recent years, quality improvement projects have been the hallmark of Doctor of Nursing Practice (DNP) programs. These programs require a project as one of the requirements for the completion of the program. Most often, the project represents a quality improvement initiative based on a problem identified by the student and supported by the leadership in the particular work setting. A rigorous process to identify the problem, the purpose of the project, objectives of the project, implementation of a potential solution for the problem, and the evaluation of the entire project are key elements.
With increasing DNP students and graduates, quality improvement projects have become commonplace in many settings. Because of this, the journal has seen an increased volume of quality improvement manuscripts. In this issue, Dr. Loker's article, "Improving Postoperative Outcomes in Lower-Extremity Amputees Utilizing a Quality Improvement Approach" (p. 144), is an example of a quality improvement project. This article illustrates the power of nurse-led quality improvement project.
The editorial board of Orthopaedic Nursing looks forward to working with authors to help disseminate their quality improvement initiatives, which, in turn, will improve care for the orthopaedic patient.
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