Script for Audio Tutorial: Nursing-Sensitive Quality Indicators

Hello and welcome to Capella Healthcare. My name is Rose Ngang, and in today’s training session, we’ll discuss the importance of nursing-sensitive quality indicators. We will learn more about how these indicators help in improving the standard of care and patient safety; how data is collected and disseminated, and, most importantly, the role of the nurse in data reporting and accountability: Script for Audio Tutorial: Nursing-Sensitive Quality Indicators.

Nursing-sensitive quality indicators are parameters that signify the structure, procedure, and consequence of nursing services. These indicators are crucial when demarcating particular sectors of concern where the nursing product is, mainly patient outcomes. This session is focused on the explanation of what these indicators are, why they were developed, and how we can, as nurses, ensure the improvement of the quality of patient care by providing more accurate statistical data.

Let’s begin. What are nursing-sensitive quality indicators?

Nursing-sensitive quality indicators, or NSQIs, are specific measures that evaluate aspects of patient care directly influenced by nursing actions. These are measures that act as benchmarks of the performance of nursing care and the patient status; as such, they act as guidelines for the enhancement of the quality of healthcare provision, as noted by Oner et al. (2020).

The National Database of Nursing Quality Indicators (or NDNQI in short) is a key resource in tracking these indicators. The NDNQI was developed in 1998 by the American Nurses Association and is a way to measure nursing outcomes and quality. The database benefits chiefs and administrators by allowing them to compare their institutional performances on a national, state, or regional level. This goes a long way in promoting the growth of best practices, hence providing the empirical basis for its delivery.

Notably, nurses play a role in patient safety and quality care in several different areas, including, but not limited to, the area of patient falls, pressure ulcer rates, staffing levels of a nurse per patient and patient satisfaction. These are only a few of the indicators that may fall under the category of nursing-sensitive indicators. These changes are taken to enhance the welfare and the quality of the lives of the patients in various health facilities.

Let’s discuss the NDNQI.

The NDNQI monitors a wide range of quality indicators and categorizes them into three main groups: structure, process, and outcome indicators.

• First, organizational structure indicators relate to the level of care capacity such as the number of qualified nurses, educational level, nurse-to-patient ratio, and features of a hospital building and equipment.
• Second, process indicators relate to activities carried out on the patient and may refer to the process being followed while handling patients. This includes tasks such as administration of medications, comprehensive nursing assessment of patients and coordination of care with other stakeholders in the health sector.
• Lastly, outcome indicators focus on the results of the care provided, such as patient mortality, infection rates, or recovery outcomes.

These categories are based on Avedis Donabedian’s structural, process, and outcome model of quality in healthcare. Ghofrani et al. (writing in 2024) note that the NDNQI supplementary assesses these indicators in order to find out their trends and benchmarks for the betterment of feedback for nursing professionals. This enables organizations to enhance their best practices and enhance the health care results of the patients.

To be precise, it is mandatory for the nurse to be well conversant with the quality indicators used by the healthcare organization. Of course, some nurses may give direct care that might affect these indicators, whereas others may be involved in the process of data collection of analysis of the outcomes.

Now, let’s delve into the NSQI of focus

Today, we will focus on one particular nursing-sensitive quality indicator, that is, patient falls. Falls are among the most frequent adverse events that occur in hospitals and the most common cause of injury in hospitalized patients. Notably, fall prevention falls under the crucial nursing care procedure, and most facilities monitor the frequency of patient falls as a part of quality indicators.

Falls often result in longer hospital stays, additional healthcare costs, and, in some cases, long-term disability. Preventing falls, therefore, is a core function within the nursing process that significantly affects patient care safety and outcomes. For this reason, Heng et al. (writing in 2020) support that the tracking of patient fall rates is considered to be a patient-sensitive quality indicator because interventions performed by the nurses, including risk assessments, patient education, and strategies to minimize the risk of falling all impact the number of falls a patient experiences.

By monitoring patient fall data, our organization can identify trends, assess the effectiveness of fall prevention strategies, and implement interventions that reduce fall rates. As nurses, we all have a crucial role in both the prevention of falls and reporting incidents in a correct manner so that the information collected is useful.

Let’s explore why it’s crucial to monitor patient falls

Fall tracking makes it easy to identify patients who are likely to fall and assess the success of measures put in place to prevent falls and increase patient safety. Falls incidence data also enable the nurses to know which interventions are effective and areas where more emphasis is required.

If, for instance, the ward records high rates of falling incidents, this may suggest that the ward lacks enough staff, training, or equipment. It may also point to a need for a better assessment protocol or more frequent monitoring of high-risk patients. By analyzing this data, nurses and other healthcare professionals can address root causes and make informed decisions about patient care.

Furthermore, fall data is often shared across the healthcare system to improve outcomes at the organizational level. Concerning the documentation of patient falls, as nurses, we ought to document fall occurrences through the use of electronic health records or other health information systems so that the data collected is accurate and can be acted upon in case of high incidents. This propounds the quality improvement objectives of healthcare systems to facilitate changes where necessary.

Now, I’d like to discuss how data is collected and distributed across the organization, with a particular focus on patient falls.

To begin with, fall data at Capella Healthcare is often collected or retrieved from electronic health records (EHR) or any other clinical databases. This is a duty performed by nurses during the rounds to ensure that all patients identified to be at a high risk of falling receive effective interventions, including the use of bed alarms and physical therapies. It is essential to record the time, place, and circumstances that lead to fall incidences and the possible injuries that the patient sustains.

The role of nurses in this data collection is critical. Nurses are usually involved in recording comprehensive and timely data into EHR, which makes it easier to extract data for aggregation. Documentation is a useful tool in the healthcare system since it enables the identification of trends regarding patient falls and subsequent interventions for improvement.

Once data is collected, it is typically disseminated or shared at the organizational level through reports generated by quality improvement teams or data analysts. These reports help administrators, department heads, and nursing leaders assess trends and identify areas for improvement. Additionally, aggregate data may be shared with staff members through team meetings or email updates, which, as noted by Javaid et al. in their 2024 article, helps to inform daily practices and foster a culture of continuous improvement.

For this reason, our responsibility as nurses involves not only the collection of data but also the assessment of the worth and accuracy of the data. Conducting thorough documentation and accurate reporting of the incidents acquired during the fall season also encourages accountability in the formulation of organizational reports and, therefore, leads to better patient safety plans.

You may ask… what is the role of nurses in ensuring accurate reporting?

Besides providing care to the patient within a shift, another basic responsibility is to capture relevant data. This includes putting vital details in the EMR, evaluating situations, and making some observations during your shift. Nursing-sensitive indicators include patient falls, among other factors, and accurate reporting is important to identify and measure such incidences for quality improvement measures. To illustrate, nurses involved in collecting data for patient falls have several responsibilities, including

1. Performing thorough fall risk assessments on all patients,
2. Documenting any falls promptly, with detailed descriptions of the incident and patient outcomes, as noted by Ernstmeyer and Christman (writing in 2021).
3. Ensuring proper use of fall prevention protocols, and reporting any gaps or issues immediately.

This accurate data can be utilized in the procedures of identifying the best approach to preventing falls within patient-differentiated care as well as providing high-quality patient care.

In conclusion, nursing-sensitive quality indicators are vital tools for improving patient care and safety. As we have pointed out, measures such as patient falls result from specific nursing actions and call for precise reporting on the impact of interventions. The duties assigned to us as nurses in data collection and the management of reports point Capella Healthcare to a better healthcare standard and increase patient safety. As a clinician, being aware of the indicators that are being captured in the organization and engaging in the process of data collection is engaging in evidence-based practice, which will enhance the delivery of healthcare.

That’s all for today. Thank you!

References

Ernstmeyer, K., & Christman, E. (2021). Chapter 4 Nursing Process. National Library of Medicine; Chippewa Valley Technical College. https://www.ncbi.nlm.nih.gov/books/NBK591807/

Ghofrani, M., Valizadeh, L., Zamanzadeh, V., Ghahramanian, A., Janati, A., & Taleghani, F. (2024). Adapting the Donabedian model in undergraduate nursing education: A modified Delphi study. BMC Medical Education, 24(1). https://doi.org/10.1186/s12909-024-05187-7

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A.-M., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BMC Geriatrics, 20(1), 1–12. https://doi.org/10.1186/s12877-020-01515-w

Javaid, M., Haleem, A., & Singh, R. P. (2024). Health informatics to enhance the healthcare industry’s culture: An extensive analysis of its features, contributions, applications, and limitations. Informatics and Health, 1(2), 123–148. https://doi.org/10.1016/j.infoh.2024.05.001

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2020). Nursing‐sensitive indicators for nursing care: A systematic review (1997–2017). Nursing Open, 8(3), 1005–1022. https://doi.org/10.1002/nop2.654

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Assessment 4 Informatics and Nursing-Sensitive Quality Indicators
Prepare an 8–10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.

Introduction
The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.

Professional Context
The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.

NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.

The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove et al., 2018).

Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.

Reference

• Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.

Preparation
As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality health care delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.

This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

• Review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
• Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.
• Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:
  • What is your experience with collecting data and entering it into a database?
  • What challenges have you experienced?
  • How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
  • What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?
    • Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar.

Recording Your Presentation
To prepare to record the audio for your presentation, complete the following:

• Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.
• Practice using the equipment to ensure the audio quality is sufficient.
• Review Using Kaltura for Kaltura to record your presentation.
• View Creating a Presentation: A Guide to Writing and Speaking. This video addresses the primary areas involved in creating effective audiovisual presentations. You can return to this resource throughout the process of creating your presentation to view the tutorial appropriate for you at each stage.

Notes:

• You may use other tools to record your tutorial. You will, however, need to consult Using Kaltura for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.
• You may also choose to create a video of your tutorial, but this is not required.
• If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact [email protected] to request accommodations.

Instructions
For this assessment, first review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.

Next, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

You determine that you will cover the following topics in your audio tutorial script:

• Introduction: Nursing-Sensitive Quality Indicator
  • What is the National Database of Nursing-Sensitive Quality Indicators?
  • What are nursing-sensitive quality indicators?
  • Which particular quality indicator did you select to address in your tutorial?
  • Why is this quality indicator important to monitor?
    • Be sure to address the impact of this indicator on the quality of care and patient safety.
  • Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
• Collection and Distribution of Quality Indicator Data
  • According to your interview and other resources, how does your organization collect data on this quality indicator?
  • How does the organization disseminate aggregate data?
  • What role do nurses play in supporting accurate reporting and high-quality results?
    • As an example, consider the importance of accurately entering data regarding nursing interventions.

After completing your script, practice delivering your tutorial several times before recording it.

Additional Requirements

• Audio communication: Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
• Length: 8–10 minute audio recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.
• Script: A separate document with the script or speaker’s notes is required. Important: Submissions that do not include the script or speaker’s notes will be returned as a non-performance.
• References: Cite a minimum of three scholarly and/or authoritative sources.
• APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
  • Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.
• Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
  • Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
• Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.
  • Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.
• Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
  • Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
  • Follow APA style and formatting guidelines for citations and references.

Scoring Guide

• Use the scoring guide to understand how your assessment will be evaluated.