NDNQI® invited 11 hospitals to share their stories of successful nursing quality improvement in this chapter. Hospitals were selected by two methods. First, regression analysis was used to rank all NDNQI nursing units based on the degree of improvement in their indicators from the second quarter of 2007 to the first quarter of 2009. The units in the top 10% that maintained improvement for at least three quarters were grouped by hospital to identify potential candidates for case studies. Second, several hospitals that presented posters at the 2009 NDNQI conference about structure and process changes that led to improved outcomes were asked to retell their stories here.

The case studies cover improvements in pressure ulcers, patient falls, hospital-acquired infections, and pediatric pain assessment. A wide variety of hospital and unit types are represented. The case studies demonstrate the quality improvement steps discussed in Chapter 2, telling: