Informatics and Nursing-Sensitive Quality Indicators
Hello and welcome to Southwest Nursing Home. The quality improvement council at Southwest Nursing Home is delighted by your presence on the nursing team and would like to share information on nursing-sensitive quality indicators. In this session, we will discuss the National Database of Nursing-Sensitive Quality Indicators (NDNQI) and nursing-sensitive quality indicators and their utility in monitoring quality in nursing care. In this tutorial, we will focus on pressure ulcer prevalence as a nursing-sensitive quality indicator. As newly recruited nurse practitioners, you play a role in accurately reporting, collecting, and disseminating data on quality indicators.
NDNQI and Interdisciplinary Team’s Role in Collecting and Reporting Data
The pursuit of quality healthcare provision underlines all healthcare operationalization, focusing on upholding high quality to benefit the patients. As integral components of health provision, nurses are implored to provide quality care that optimizes clinical outcomes and enhances patient experiences. NDNQI is a nursing database that provides periodic reporting on structure, process, and outcome indicators utilized in evaluating nursing care in various care settings. Data from NDNQI can be reliably and validly used to inform on linkages between staffing and patient outcomes and experiences, evaluate nursing care, and influence policies targeted at improving nursing care. Do you need help with your assignment ? Reach out to us at eminencepapers.com.
Nurses and other healthcare professionals in interdisciplinary healthcare teams play a role in data collection and reporting on quality indicators. In modern healthcare, where healthcare information technologies such as electronic medical records are integrated into care operationalizations, interdisciplinary team members can collect data on patients’ hospital stay days that may put them at risk for developing pressure ulcers. Other patient data, such as commodities and pain that often accompanies pressure ulcers, can also be obtained from these healthcare technologies. The interdisciplinary team is strategically placed to collect data on these indices and accurately report them to enhance patient safety, care outcomes, and organizational performance reports.
How a Healthcare Organization Uses Nursing-Sensitive Quality Indicators
Quality improvement measures in nursing remain a fundamental role of nurse practitioners, focusing on safe, effective, efficient, and patient-centered care. Nurse-sensitive indicators define specific patient outcomes used in monitoring quality nursing care. These indicators are influenced by nursing care and a demonstration of the effectiveness of quality improvement measures undertaken by healthcare systems and individual nurses (Oner et al., 2020). Nurse-sensitive quality indicators promote a quality improvement continuum in a healthcare organization and provide an evidence-based approach to the implementation of quality improvement initiatives.
Pressure ulcer prevalence is an example of a nursing-sensitive outcome indicator that has been used to inform on the hospital’s safety, outcome, and organizational performance. Healthcare technologies such as EHR maintain significance in the identification of quality indicators. Factors within patient handling and patient care, such as increasing intensity of pain, deterioration of the patient conditions, medications are taken, and hospital stay days that these technologies can capture, may give insight into underlying complications such as the development of pressure ulcers. As newly recruited nurses, you are our foot soldiers in this respect. Your ability to identify patient factors that are reflective of poor outcomes may enable the identification of these quality indicators to enhance care outcomes, the safety of the patients, and organizational performance reports.
Healthcare organizations should, in this regard, invest in healthcare technologies, such as EHR, as a measure for enhancing the safety of the patients and care outcomes. The Southwest Nursing Home is a pioneer in EHR use. Its move to integrate these technologies into its framework for operationalization was informed by the need to uphold quality and utilize evidence-based approaches to identify and inform quality improvement areas.
Nursing Sensitive Quality Indicator
Pressure ulcer prevalence is a nursing-sensitive quality indicator that demonstrates the effectiveness of nursing interventions on patients. Pressure ulcers primarily affect patients who are confined in one body position for a long time. This may be those having mobility issues and thus remain sited for long or bedridden patients. As a nursing care facility, a significant proportion of our clients are those vulnerable to pressure ulcers. According to Stone (2020), the prevalence of pressure ulcers among hospitalized patients in U.S. nursing homes ranges from 2-24%. The primary intervention to prevent the development of pressure ulcers is turning the patient. Nurses are tasked with the responsibility of frequently turning the patient as prescribed to lower their chances of developing pressure ulcers.
Healthcare technologies in current medical use, such as electronic health clinical decision support systems, can aid in managing and preventing pressure ulcers. These technologies may alert nurses on when to turn the patients and hence lessen the pressure on the affected area. These technologies can also be used to identify patient factors such as pain, which is indicative of a worsening prognosis, thus informing on management approaches (Ting & Garnett, 2021). Nurses should be knowledgeable about these technologies to better their reporting on pressure ulcer prevalence as a nursing-sensitive quality indicator. Nurses’ neglect has been implicated in many cases of pressure ulcers (Lee et al., 2019). This informs the need for you, as recruits to the nursing team, to embrace the use of these technologies to enhance care outcomes and ensure patients’ safety and satisfaction with the care processes.
Collection and Distribution of Quality Indicator Data
The Southwest Nursing Home collects Data on pressure ulcers periodically. This Data is obtained from the electronic health records system that is integrated into the hospital’s framework of care provision. It also urges nurses to report such cases whenever they occur. In this regard, it has created a system for anonymous reporting to safeguard the confidentiality of the reporter. Upon collecting data on this quality indicator, the hospital, through the quality improvement council, disseminates this information to interdisciplinary healthcare teams via written memos and emails to fast-track the management of the affected patients.
Nurses play an important role in supporting accurate reporting and high-quality results. Their contact time with the patients places them in a strategic position to identify such cases promptly. Nurses have the ethical obligation of nonmaleficence, which requires them to do no harm (Girdler et al., 2018). In this regard, they are required to conform to this ethical provision by accurately reporting such incidences to ensure the safety of the patient and optimal clinical outcomes. Accurate reporting is important because it enables prompt address of the quality indicator and measures for quality improvement regarding the reported quality indicator. As newly hired nurses, you play a significant role in the accurate reporting of quality indicators. Your concerted efforts in both data collection and reporting will ensure quality improvement, safety, performance enhancement, and improvement in care outcomes.
In conclusion, I want to once more welcome you to the nursing team. We look forward to working with you. Remember, quality improvement is a fundamental nursing role. You are, therefore, required to embrace all quality improvement measures in the hospital. Understanding nurse-sensitive quality indicators is key to nurses as it helps them identify quality issues in their care processes. With technological advances in healthcare and the utilities of these technologies in identifying quality indicators, nurses should be ready to embrace these technologies to promote the safety of the patients, enhance their performance and improve clinical outcomes.
References
Girdler, S., Girdler, J., Tarpada, S., & Morris, M. (2018). Nonmaleficence in medical training: Balancing patient care and efficient education. Indian Journal Of Medical Ethics, 01-05. https://doi.org/10.20529/ijme.2018.100
Lee, Y., Kim, J., Dong, C., & Park, O. (2019). Developing risk-adjusted quality indicators for pressure ulcers in long-term care hospitals in the Republic of Korea. International Wound Journal, 16, 43-50. https://doi.org/10.1111/iwj.13024
Oner, B., Zengul, F., Oner, N., Ivanova, N., Karadag, A., & Patrician, P. (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
Stone, A. (2020). Preventing Pressure Injuries in Nursing Home Residents Using a Low-Profile Alternating Pressure Overlay: A Point-of-Care Trial. Advances In Skin &Amp; Wound Care, 33(10), 533-539. https://doi.org/10.1097/01.asw.0000695756.80461.64
Ting, J., & Garnett, A. (2021). E-Health Decision Support Technologies in the Prevention and Management of Pressure Ulcers. CIN: Computers, Informatics, Nursing, 39(12), 955-973. https://doi.org/10.1097/cin.0000000000000780
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Question 
Prepare an 8-10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.
Introduction
As you begin to prepare this assessment, you are encouraged to complete the Canadian Quality Assessment Framework activity. Quality healthcare 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.
Informatics and Nursing-Sensitive Quality Indicators
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.
The focus of Assessment 4 is on how informatics supports the 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.
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
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:
Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system. Choose from the following list:
Staffing measures.
Nursing hours per patient day.
RN education/certification.
Skill mix.
Nurse turnover.
Nursing care hours in emergency departments, perioperative units, and perinatal units.
Skill mix in emergency departments, perioperative units, and perinatal units.
Quality measures.
Patient falls.
Patient falls with injury.
Pressure ulcer prevalence.
Healthcare-associated infections.
Catheter-associated urinary tract infection.
Central line catheter-associated bloodstream infection.
Ventilator-associated pneumonia.
Ventilator-associated events.
Psychiatric physical/sexual assault rate.
Restraint prevalence.
Pediatric peripheral intravenous infiltration rate.
Pediatric pain assessment, intervention, reassessment (air) cycle.
Falls in ambulatory settings.
Pressure ulcer incidence rates from electronic health records.
Hospital readmission rates.
RN satisfaction survey options.
Job satisfaction scales.
Job satisfaction scales – short form.
Practice environment scale.
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 the quality improvement monitoring results with the nursing staff and other members of the health care system?
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 the 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 DisabilityServices@Capella.edu to request accommodations.
Instructions
For this assessment, 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.