Quality Resources and Improvement Activities

Quality Resources to Support Evidence-based Practice (EBP) and Quality Improvement

Nursing plays a critical role to identify and eliminate waste while actively improving systems and care delivery, all resulting in improved patient experiences and outcomes. ONS offers resources to inform healthcare professionals about quality reporting with an emphasis on improvement.

Evidence-based practice is a problem-solving approach to clinical practice that integrates the conscientious use of best research evidence in combination with clinician expertise as well as patient preferences and values to make decisions for care that will promote the optimal outcome.

Quality improvement (QI) is a method of improving clinical processes through the use of quality tools and methods with the goals of the activity depending on the practice gap identified in the performance data.

  • LEAN Healthcare – QI tools that help identify sources of waste in a clinical process and replace those non-value adding activities with those value adding practices that improve outputs and clinical outcomes.
  • Six Sigma – QI tool that aims to reduce impractical variation in processes and clinical practice between clinicians. Variation increases costs and often indicates lack of EBP utilization on the part of clinicians.
  • Model for Improvement – QI tools that utilize testing of ideas and hypothesis about what we might change to achieve EBP and improved outcomes using small tests of change often called PDSA cycles.

Data-Driven Quality Improvement refers to the use of scientifically tested quality metric to measure nursing sensitive and patient centered key performance metric to identify gaps in practice and variations between clinician and practice sites. These data are needed to determine greatest opportunities for improvement in practice to prioritize improvement activities.

ONS EBP and EBQI Resource Matrix


ONS Practice Resource

Quality Metric and Other Resources

Cancer-Related Fatigue

ONS Fatigue PEP Resources

  1. Assessment for Fatigue – process measure
  2. Recommendation for Exercise in Adult Cancer Survivors – process measure
  3. Fatigue Improvement – outcome measure

Health-related Quality of Life


Health-related Quality of Life (HRQoL) in Advanced Cancer – outcome measure

Immune Mediated Adverse Events

ONS Immunotherapy-induced Diarrhea PEP Resources

Immune-mediated Adverse events – intermediate clinical outcome measure

Sleep-Wake Disturbance

ONS Sleep-Wake Disturbance PEP Resources

Assessment and Intervention for Sleep-Wake Disturbance during Cancer Treatment – process metric

Prevention of Infection: General

ONS Prevention of Infection – General PEP Resources

Education on Neutropenia Precautions – process measure

Anxiety and Depression

ONS Anxiety PEP Resources

ONS Depression PEP Resources

Assessment and Intervention for Psychosocial Distress in Adults Receiving Cancer Treatment – process measure

Other Resources for Cancer-Related Fatigue: