Misalignment between research and quality improvement terminology in published nursing reports: A descriptive study

Quality improvement (QI) is a type of inquiry distinct from research with separate implementation designs and evaluation methods; however, many publications conflate QI terminology when research designs and methods are used.

The purpose of this study was to objectively quantify misalignment in QI reports by assessing concordance between stated project implementation design and evaluation methods with actual designs and methods used.

A descriptive cross-sectional design was used. The first 2025 issue for all journals listed in the Nursing Journal Directory was sought for review. Articles in which QI was the stated design/method were extracted.

Two hundred fifty journals and 5,398 articles were reviewed, of which 75 were labeled as QI reports. Seventy-three full-text reports were retrieved, of which only 19.2% (n = 14) used QI implementation designs (i.e., implemented practice changes through iterative cycles) and 6 (8.2%) appropriately evaluated data using QI methodology. Most articles (58.9%, n = 43) employed a pre/post quasi-experimental research design using inferential statistical tests to determine differences before and after an intervention was implemented.

Results of this study quantify the misalignment between stated project implementation design and evaluation methods with actual methods and designs used. Academic program leaders, faculty, clinicians, ethical review board personnel, peer reviewers, and journal editors are encouraged to reflect on these results and ensure they can appropriately distinguish between QI and research designs and methods.