Informatics and Nursing Sensitive Quality Indicators
Hello and welcome to the (—Hospital). My name is AN. OTHER. I am here to welcome you as you become a valuable member of the organization. My focus today is to help you understand what quality is and what are the indicators for quality care that we as a hospital adhere to. In this video presentation, I will focus on helping you understand how we utilize Nursing Sensitive Quality Indicators or the NDNQI to help achieve our care quality goals. Therefore, I will answer questions like “What is the National Database of Nursing-Sensitive Quality Indicators?” “What are nursing-sensitive quality indicators?” How can we collect and distribute data on quality indicators? I will also focus on your role as a nurse and how you can collaborate within interdisciplinary teams to improve the utilization of patient care technology and electronic health information to support decision-making. Explain how the hospital employs nursing-sensitive quality metrics to improve organizational performance reporting, patient safety, and patient care outcomes.. I will also provide recommendations on how technology can be used to raise patient quality and safety standards.
Nursing-Sensitive Quality Indicator
First, let us start by looking at what NDNQI is, the nursing-sensitive quality indicators, and why you need to be familiar with these indicators during your practice.
In simple terms, the NDNQI is a database developed and maintained by the American Nurses Association (ANA). The rationale behind the NDQNI is to provide a framework for measuring and tracking nursing-sensitive quality indicators in healthcare facilities. The ANA utilizes data from all healthcare providers and organizations across the country and uses these data sets to design frameworks to improve nursing care and compare performance across the U.S. This now brings us to an understanding of what the nursing-sensitive quality indicators are. Nursing-sensitive quality indicators are the measures employed in various nursing care fields that are viewed against patient outcomes. With regards to patient outcomes, the nursing-sensitive are measured based on the quality of nursing care. Afaneh et al., in their concept analysis paper published in 2021, focused on analyzing these nursing-sensitive indicators to identify some main NSIs such as the levels of staffing, incident rates within care settings such as falls, medical errors, hospital-acquired infections (HAIs), and levels of patient satisfaction.
Now, let me give you an example of a simple and complex nursing-sensitive indicator you will be required to observe, maintain, and track, such as patient satisfaction. Why are these indicators important to monitor, and how do they impact the quality of care and patient safety? First, patient satisfaction. In a study published in 2019 by Manzoor et al., the authors show that the level of patient satisfaction with the healthcare services provided was largely influenced by the patient’s perception of the provider’s behaviours. Additionally, Karaca and Durna, in another 2019 study, showed that patient satisfaction was directly related to how the patients perceived the quality of care provided. Therefore, new nurses need to be familiar with these nursing-sensitive indicators during their practice as they form the foundation for analyzing, measuring, determining, tracking, and improving the quality of nursing care.
Collection and Distribution of Quality Indicator Data
As I noted earlier, the ANA, in developing, maintaining, and updating the NDNQI, utilizes data from various healthcare organizations and settings across the U.S. This means that even our own hospital is a part of the contribution to the development of the NDNQI. You should have an insight into how we collect data on patient satisfaction and how we share that data. We usually conduct surveys focusing on patient experiences during and after the process of care. This means from their point of entry into the system to the point of exit and follow-ups on care. We focus on multiple aspects throughout the process, such as their interactions with care providers, their stay, and other safety and quality aspects. The dissemination of aggregate data, whether internally or externally, is done through print, sharing digital articles on the same, holding workshops and presentations done for specific providers, or in general healthcare organizations’ conferences. The aggregated data from these interviews show the quality and safety of nursing interventions employed within the various care settings. These sets of data need to be as thorough and accurate as possible when entered. Besides improving the analysis and presentation of the data, accurately entering nursing interventions’ data can improve our compliance with current regulations, our patient planning and scheduling for services and procedures, and the efficiency of patient accounting and making claims. It also supports the process of decision-making.
Nurses’ and the Interdisciplinary Team’s Role in Informatics and The Use of Electronic Health Information and Patient Care Technology to Support Decision-Making
At this point, you may wonder what your role is and what you can do to improve the NDNQI. Right?
You should be aware that, regardless of the care settings you will ever practice in, you will always work within a team with practice backgrounds from different disciplines. In such interdisciplinary teams, you, as a nurse, will always be a critical healthcare provider with the most patient conduct. You have the highest influence on and collect first-hand data on all the nursing-sensitive indicators. In such practice settings, you will always be required to understand how to use patient care technologies and informatics to collect patient information. Every data point entered into these systems, from simple patient monitoring systems such as blood pressure and heart rate monitors to electronic health records systems (EHRs) and conversations with patients, will be continuously collected, analyzed, shared, and stored patient data. The collected, stored, shared, and analyzed data using these electronic information and patient care technologies is critical in supporting the process of making decisions within your practice to design and implement approaches that enhance patient safety, patient care outcomes, and organizational performance.
Impact of Patient Care Technologies on Desired Outcomes
As earlier noted, the nursing-sensitive quality indicators form the foundation of analyzing, measuring, determining, tracking, and improving the quality of nursing care. Using patient care technologies, it is possible to monitor patients, collect data on these indicators, and analyze and utilize such data to enhance patient safety, patient care outcomes, and organizational performance reports. For instance, you can collect data focused on patients’ length of stay and how it affects their level of satisfaction or their time and level of interactions with the physicians and how it improves their perception of care quality and level of satisfaction. You can also use technologies such as telehealth and telemedicine to monitor patients remotely and improve their outcomes. Arguably, a study by Groom et al. concluded in 2021 that the use of patient care technologies such as telehealth and telemedicine improved the experiences of patients and providers and aided in the early detection of symptoms, which had a significant influence on the reduction of costs of care, risks of admission or readmission.
Recommendations on the use of Technology to Enhance Quality and Safety Standards for Patients
Before I conclude, I recommend that you learn more on the NDNQI from the ANA website. You will get to learn more about how nursing-sensitive quality indicators such as patient satisfaction establish evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes. For instance, from the studies by Karaca and Durna and Manzoor et al. relating the level of patient satisfaction as indicators for provider behavior and quality of care provided, it is possible to use this indicator as the basis of implementing strategies that establish provider behaviors that patients as recipients of care perceive as satisfying. Conclusively, understanding the NDNQI and your role in this development is essential to ensuring the provision of quality and safe care to patients and your personal safety and career development.
References
Afaneh, T., Abu-Moghli, F., & Ahmad, M. (2021). Nursing-sensitive indicators: a concept analysis. Nursing Management (Harrow, London, England : 1994), 28(3). https://doi.org/10.7748/NM.2021.E1982
Groom, L. L., McCarthy, M. M., Stimpfel, A. W., & Brody, A. A. (2021). Telemedicine and Telehealth in Nursing Homes: An Integrative Review. Journal of the American Medical Directors Association, 22(9), 1784-1801.e7. https://doi.org/10.1016/J.JAMDA.2021.02.037
Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing Open, 6(2), 535–545. https://doi.org/10.1002/NOP2.237
Manzoor, F., Wei, L., Hussain, A., Asif, M., & Shah, S. I. A. (2019). Patient Satisfaction with Health Care Services; An Application of Physician’s Behavior as a Moderator. International Journal of Environmental Research and Public Health 2019, Vol. 16, Page 3318, 16(18), 3318. https://doi.org/10.3390/
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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 focuses 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 healthcare 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.
The 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 that is 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 courtroom, 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 it important to monitor this quality indicator?
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 courtroom, 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 healthcare organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
Competency 4: Recommend the use of 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 the 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.