Nurses are accountable in leading efforts to advance translational science, particularly in the development of clinical practices and care delivery systems that result in quality patient care and improved outcomes. To provide nurses a foundation for integrating science into practice and policy, this chapter provides a useful review and critique of current translational science models, implementation of intervention research, program evaluation, and translational science in the practice setting. The nursing profession has a long history with translating research findings into practice and is increasingly expected to engage in translating research evidence into clinical practice and healthcare policy. Translational theory may effectively guide the design of the intervention study to evaluate the effects of the intervention, interpret study results, and help translate the intervention to real-world settings. Key to these efforts is ensuring the presence of construct validity and having a structured project management approach.

This chapter helps the reader to identify characteristics of formal and informal leaders, describe ways nursing leaders encourage an organizational spirit of patient-centered inquiry and to outline a plan for implementing an evidence-based practice (EBP) healthcare culture. It addresses the roles of formal and informal leaders in developing and sustaining an organizational culture of EBP. Healthcare settings with an embedded EBP culture demonstrate the EBP process as normative and expected behavior of nurses' everyday work life. Effective nurse leaders understand the organization's overall purpose and goals for establishing an EBP culture. Nurse leaders are clear about the needs of the organization's participants to help EBP grow and thrive as a means of delivering high-quality patient care. The chapter highlights ongoing strategies that effective nurse leaders use to attain and uphold an EBP culture. It explores the underreported, yet vitally important, role that informal leaders have in fostering an EBP culture.

Providing the highest quality of care to clients, and keeping them safe, is a priority for all nurses. This chapter presents an evolving case scenario that will follow a nurse's exploration of quality and safety on her patient care unit. It helps the reader to define quality improvement and safety in healthcare. The chapter describes approaches that nurses can take to evaluate the quality of care through measurement and benchmarking. It helps the reader to explain the influence of variation on the quality of care and apply a framework to improve reliability. The chapter differentiates prepatient events, safety events, and serious safety events and describes how human factors contribute to events of harm. It defines the culture of safety and its elements, including event reporting, event disclosure, and accountability in a just culture. The chapter finally explains the process for determining actual and potential failures in processes.

Palliative care (PC) and hospice nursing reflects a holistic philosophy of care implemented across the life span and diverse health settings. PC and hospice nurses relieve suffering along the course of illness, through the death of the patient, and into the bereavement period of the family. This chapter presents an evolutionary perspective of hospice and palliative care nursing. The standards of practice in PC and hospice nursing describe a competent level of generalist and advanced practice registered nursing care as demonstrated by the nursing process. The standards of professional performance require the integration of specific core competencies aimed at ensuring the delivery of safe, quality patient-centered care, including the demonstration of competent professional role behaviors in practice, education, research, and leadership. PC nurses collaborate with all members of the interprofessional team, to insure quality and continuity of care in meeting the needs of patients and their families.

Nursing research provides the scientific bases for practice, and nurses are interested in finding the most effective approaches to achieving and sustaining optimal patient-centered care. To help determine the credibility and usefulness of research to practice, this chapter provides basic guidelines for reviewing and critiquing quantitative and qualitative research reports. It focuses on assessment of research quality. In research, quality is defined as the extent to which a study has minimized bias in the selection of participants, measurements, and external factors that may have an impact on the study's results. The chapter emphasizes the role of nurses' use of research as a component of evidence-based practice to answer practice questions, solve problems, enhance the quality of patient care, and shape important healthcare decisions. It reviews basic terms and provides checklists and suggestions that support nurses in the appraisal of research prior to translating the research into practice.

This chapter explores deficiencies associated with healthcare quality as a result of overuse, underuse, and/or misuse of healthcare services. It describes evidence-based practice (EBP) as a method by which many of these gaps in services can be effectively and ethically diminished. The chapter helps the reader to recognize barriers to implementing EBP, recommend ideas to support and enhance EBP facilitators, describe the state of healthcare quality, understand the role of EBP in improving healthcare quality, and to identify potential ethical concerns related to the use of EBP. Clearly, the relationship between EBP and ethics is complex and problematic. There is much to be gained from further scholarly exploration of this relationship. In the meantime, it is important for nurse managers and leaders to assume the responsibility of integrating sound ethical frameworks or models for clinical decision making in areas where EBP is used to inform patient-centered care.

Data standardization supports the goals of nursing to improve direct patient care and healthcare safety and quality. By allowing comparison of patients across healthcare systems and settings, data standardization has the potential to enhance the evidence basis for nursing practice and to improve clinical outcomes. Data standardization has the potential to decrease the costs of healthcare to patients and organizations by improving reimbursement, decreasing unnecessary testing, and streamlining the processes like nursing and physician documentation, giving providers more time to care for patients directly. Professional nurses with knowledge of data standardization are empowered to advocate on behalf of the discipline and patients to improve machine readability of nursing documentation and to improve care. This chapter helps the reader to define data standardization, and discuss the rationale for standardizing nursing-generated data and the differences and applications for standardized nursing nomenclatures.

Patient-Centered Medical Homes are models of practice that seek to improve healthcare quality and patient engagement through enhanced technology and care coordination within primary care. Use of the medical home is an approach that is patient-centered and supports patients and families by assisting them to manage healthcare decisions and involving them in their care planning. The primary care team helps patients follow their plans of care, thereby meeting their goals using coaching and advising techniques. There is also opportunity for the medical home to connect patients with peers in the community who share similar health issues and experiences to provide support and encouragement. Medical homes have infrastructure to coordinate care and provide support to patients with chronic conditions such as stroke. This chapter describes the prevalence and effects of stroke and how practicing in a medical home model can provide secondary and tertiary prevention strategies to assist in stroke recovery.

According to the National Institute on Aging (2019), hundreds of thousands of adults over the age of 60 are abused each year. Elder abuse is often under the umbrella of elder mistreatment, which includes abuse, neglect, and exploitation among individuals aged 65 or older. This chapter describes risk factors, types of elder abuse, and approaches for prevention and treatment. Advanced practice nurses must be prepared to report as mandated by law, be advocates for prevention and treatment while meeting the needs of elderly patients to ensure quality care. Elder abuse is defined as an act or lack of an appropriate action that results in harm or distress to an older person. The chapter helps the practitioners to: recognize signs and symptoms of elder abuse; summarize laws pertinent to elder abuse; describe factors that contribute to elder abuse; and identify how to respond to needs related to elder abuse.

This chapter explores how effective project management (PM) techniques can guide improvement in health care quality, safety, and patient outcomes. It defines project management and explores the key concepts. In today's health care environment, every health care member is responsible for and contributes to quality improvement (QI) translation and sustainability. The chapter introduces the nurse as an integral interprofessional team member and discusses how frontline workers are crucial in QI projects. Using PM techniques increases QI project success. The PM techniques include the five phases of initiating, planning, executing, monitoring, and controlling, and closing. The chapter defines each phase and also demonstrates how the nurse answers a current health care problem using PM techniques. It discusses leadership and management characteristics required during PM and then highlights nursing leadership skills central to managing interprofessional teams and QI projects. Finally, the chapter examines PM benefits and limitations.