A new study, "New Nurses' Views of Quality Improvement Education," published in the January 2010 issue of The Joint Commission Journal on Quality and Patient Safety finds despite the strong focus on quality improvement (QI) in hospitals, 38.6 percent of novice nurses feel they were "poorly" or "very poorly" prepared in their nursing education programs to implement QI measures or "had never heard of" QI.

With support from the Robert Wood Johnson Foundation (RWJF), the researchers analyzed the survey responses from 436 newly-licensed registered nurses from 34 states and the District of Columbia (69.4 percent response rate). While many nurses may observe problems and understand the need for improvement, many felt unprepared to undertake the actions necessary to do so.

QI is a systematic, data-driven set of activities designed to bring about immediate improvement in the delivery of healthcare and ultimately in patient outcomes. A growing body of research shows a direct link between nurses' actions and patient safety, quality of care, and cost savings as a result of improvements, according to the Joint Commission.

Survey participants' views of their QI preparation varied dramatically depending on the specific content area. For example, a majority felt they were "very prepared" in patient-centered care, yet half of participants felt they were "not at all prepared" to utilize specific QI techniques, such as root-cause analysis.

Those respondents to the sturdy who had earned bachelor's degrees reported significantly higher levels of preparation than associate degree program graduates in evidence-based practice, assessing gaps in practice, teamwork and collaboration, as well as many of the research skills such as data collection, analysis, measurement, and measuring resulting changes.

In an accompanying editorial, "Quality Improvement Education for Nurses: We Can Do Better," noted nurse staffing researcher, Peter I. Buerhaus, PhD, RN, FAAN, Valere Potter Professor, Vanderbilt University School of Nursing, called the results "disturbing" and added they "provide a wake-up call to educators and employers that they must do better."

Still, many novice nurses did not perceive their QI training from their employers as helpful, prompting the study authors to suggest this finding required additional study. The authors also recommend nurse educators partner with hospitals to implement more effective QI education, jointly introducing students to the methods healthcare organizations use and make specific QI projects a requirement for graduation.