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Measuring and Monitoring Quality of Care Delivered by an APN
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Measuring and Monitoring Quality of Care Delivered by an APN
One of the most important things to consider when assessing the quality of care an
advanced practice nurse provides is the percentage of positive health outcomes that are
achieved. The best way to measure this is by examining outcomes over time. To monitor the
quality of care an APN provides, the clinician should assess their current patient outcomes
and compare them with their previous patient outcomes quarterly. The clinician should also
regularly reassess their practice (also quarterly) to identify areas requiring additional work or
improvement (Parker & Hill, 2017). Once these areas have been identified, the clinician
should create an action plan that outlines concrete steps for improvement. This plan should be
revisited twice yearly and updated as necessary as part of a continuous improvement process.
The critical elements to the action plan of improving the quality of care provided by
an APN include data capture, ongoing monitoring, provision of feedback to the APN, and
continuous improvement. Ongoing quality improvement and continuous learning lead to a
sustained quality of care (Schober & Stewart, 2019). APNs should evaluate the quality of
care provided by themselves regularly with a process that includes an evidence-based
assessment instrument for each domain they practice in or monitor. There are many examples
of these instruments; one example is the SPOT method (standardized patient observation
tool) (Parker & Hill, 2017). The process should also include systematic monitoring of data
collection for performance indicators associated with each domain practiced or monitored by
the APN.
An APN should evaluate the self-assessment results and compare them to evidencebased benchmarks from the literature or other sources. The APNs should assess whether the
quality of care is at an appropriate level relative to the benchmark standards for what is
considered good, effective, or optimal practice (Schober & Stewart, 2019). The APN should
also consider gaps in clinical knowledge obtained by education through ongoing learning
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activities and potential course correction strategies for ongoing care such as consultation with
peer APNs or other specialists.
Suppose it is determined that the quality of care provided by the APN is below the
benchmark standard. In that case, corrective actions should be taken immediately to improve
the quality of care. Corrective measures may involve further staff education, consultation
with peer APNs or other specialists, and in-depth self-improvement activities. Examples
include attendance at a workshop or formal course, participation in an online advanced
practice nursing continuing education program such as the Medical Learning Institute,
reading professional advanced nursing practice textbooks, and purchasing relevant clinical
study articles for one’s ongoing learning program (Parker & Hill, 2017). If done correctly,
this process can improve the quality of care an advanced practice nurse provides. Although
the process may be labour-intensive and time-consuming at first, it will become a valuable
tool for all advanced practice nurses once it is in place. The process is also evidence-based
which means that it uses factual data to solve an existing problem currently being
experienced in the health industry, thus helping to improve the profession.
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References
Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the United
States, Canada, Australia and Hong Kong special administrative region (SAR), China.
International Journal of Nursing Sciences, 4(2), 196-204.
Schober, M., & Stewart, D. (2019). Developing a consistent approach to advanced practice
nursing worldwide. International nursing review, 66(2), 151-153.