Informatics and Nursing Sensitive Quality Indicators Video Script

Informatics and Nursing Sensitive Quality Indicators Video Script

Hello everyone. Welcome to the University Hospital Health Care System. My name is Dora, and I feel honored to have you as part of this amazing team. I remember my first days as a nurse, the excitement and anxiety of transitioning to the workforce. With the help of my mentors and supervisors, I have been able to grow not just professionally but personally. I would also like to help you have a smooth transition and increase your understanding of some of the important things in the organization.

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Today, I will take you through the National Database of Nursing Quality Indicators, abbreviated as NDNQI, and explain how our organization makes use of the NDNQI to improve patient care and satisfaction by ensuring safety and quality care. The NDNQI is considered the only national nursing database that offers annual and quarterly reporting of the structure, outcome, and process indicators to assess nursing care at the unit level.  The importance of data from the NDNQI is that it is reflective of the correlation made between direct patient care, staffing ratios, and quality outcomes (Lockhart, 2018). The NDNQI generally helps us to make sure that a comparison is made between mangos and mangos and not mangos and oranges, and such comparison enables us to know how we compare or benchmark against other organizations at the national level.

Nursing sensitive indicators from the NDNQI reflect three aspects of nursing care, namely: structural indicators (such as nursing staff skill level and nursing staff), process indicators (such as nursing job satisfaction and patient assessment), and outcome indicators related to the quality of care (reflected by things like falls, pressure ulcers and hospital readmissions). Generally, some of the nursing-sensitive indicators include patient falls, hospital-acquired infections, medication administration errors, pressure ulcers, and length of stay, among others.

In this video, I would like to focus on medication administration errors because this has been one of the most troublesome areas not only in this organization but nationally. Research shows that in the US, medication errors are the eighth leading cause of death, and its cost is about $42 billion annually (Wondmieneh et al., 2020).  It is very sad that such errors are commonly made by nurses. Nurses who fail to follow the 5 rights (right patient, right drug, right dose, right route, and right time) of medication administration play a major role in medication errors, and some of the reasons why this happens include miscalculations, increased workload, distractions, fatigue, and pharmacologic knowledge deficit). Naidu and Lee (2019) report that in a span of one year, some hospitals reported a total of 65 percent of medication administration errors. Such errors can be costly because they can cause severe harm to patients, endangering their safety, and could even result in disability or death. In most cases, such errors also have legal repercussions, and some nurses have even been fired for it. However, I would not like to scare you because one of the reasons for the high rate of medication errors is the lack of reporting by nurses due to their fear of punitive actions. Our organization noticed such things and decided to take on another route, where thorough training is given to nurses to prevent such errors, and a culture of openness and reporting is encouraged. Medication errors also have costly impacts on the psychological well-being of nurses because they could lessen their confidence and cause them high anxiety and low self-esteem. To improve patient safety and also boost your confidence as a nurse, which will improve your job satisfaction, it is important to address the issue of medication administration errors in order to improve your ability to deliver quality care to patients.

In this organization, we thrive and boast on the fact that our nurses and other healthcare practitioners are able to make incident reports on medication administration errors, hence allowing us to obtain data on such errors. Reporting is part of getting rid of the problem because it will enable us to correct the mistake and ensure patient safety and also offer the necessary training to the nurse. Since we noticed a 25 percent increment in the rate of medication administration errors in a span of 1 year, it was necessary to embrace a new technology to lessen these errors. Furthermore, we could not just depend on individual reports because not everyone might have the confidence to report these errors, no matter how much we emphasize their importance. Therefore, our company decided to implement a barcode medication administration. This technology was recently implemented (about 6 months ago), and training is done on a weekly basis to ensure that everyone learns about its use since collective action is needed to improve patient safety.

A team of experts, together with our team of nursing informaticists, take part in computerized monitoring of the use of the barcode technology to collect data on medication administration errors and also to assess the skills and knowledge of nurses in the use of the technology. Do not worry; you will also be thoroughly trained on its use. Data collection on the errors is usually followed up with a questionnaire or online survey prepared by our team of nursing informaticists to find out important things such as the cause of the error (inattention or lack of proper pharmaceutical knowledge, among others) and the point when the error was made (administration or prescription among others). After all the data on medication administration errors is collected, the nursing informatics team, together with our organization statisticians, compose an in-depth report with charts and bar graphs showing percentages of the errors, progress, or lack thereof made after the barcode technology was implemented and other things.

Now, I would like to finalize this video by giving you ideas on what you could do to help in the entire process. I cannot emphasize enough the importance of reporting medication administration errors. It is important for you to note that man is to error, and therefore, making such errors does not necessarily mean that you are bad at your job. Not to mention, the health of patients is in line, and so is our reputation if such mistakes are not corrected. Our rule is to do no harm, and therefore, I plead with you to make reporting a habit. The data collected from such reports will also help us find better interventions to reduce the problem since even technology might not be 100 percent effective in eliminating medication administration errors.

Research by Hammoudi, Ismail, and Abu Yahya (2018) shows that poor communication is among the major causes of medication errors hence the need for teamwork and improved communication to lessen the problem. We thrive in openness and mutual respect. In an interdisciplinary team, every member is important. We need collective action to improve the care and safety of patients. The NDNQI data can help us make such improvements. The data helped us realize the need for barcode technology, and ever since we implemented it, our organization has recorded a 30 percent decline in the number of medication errors. Most of the errors can be attributed to the fact that most nurses are still learning how to use it.

We, as an organization, promise to offer you the necessary help to have an easy transition to the workplace. Teamwork will be needed to help us eliminate some of the problems we face, such as medication administration errors and the harm caused to patients and caregivers. The first step towards eliminating the problem has been getting involved in the NDNQI, which has helped us improve patient safety and care. I cannot emphasize enough the importance of openness, teamwork, and collaboration. Report! Report! Report! Also, make suggestions on how we can improve our efforts to reduce medication errors. In comparison with other local hospitals, we rate highly in regard to medication errors. The NDNQI data helped us make this comparison and also led us to the implementation of the barcode technology, which has lessened such errors. We rely on you to help us continue collecting data so as to improve the safety and care of patients. Once again, I am so glad to have you on our team, and I look forward to working and learning from you.

Thank you!

References

Hammoudi, B. M., Ismail, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046.

Lockhart, L. (2018). Measuring Nursing’s Impact. Nursing made Incredibly Easy, 16(2), 55.

Naidu, M., & Alicia, Y. L. Y. (2019). Impact of bar-code medication administration and electronic medication administration record system in clinical practice for an effective medication administration process. Health, 11(05), 511-526.

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(1), 1-9.

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