Assignment Informatics and Nursing-Sensitive Quality Indicators Essay

Assignment Informatics and Nursing-Sensitive Quality Indicators Essay

Assignment Informatics and Nursing-Sensitive Quality Indicators Essay

Assignment Informatics and Nursing-Sensitive Quality Indicators Sample Essay

Hello everyone. Welcome to this video presentation, where I will discuss a nursing-sensitive quality indicator. I will also discuss how our organization collects and distributes data on the quality indicator and your role in this.

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I will start by enlightening you on the National Database of Nursing Quality Indicators (NDNQI®). This is a national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators used in the assessment of nursing care at the unit level. The database provides healthcare organizations with performance reports that allow administrators to compare their data with national averages, percentile rankings, and other essential information (Oner et al., 2021). Secondly, I will explain what nursing-sensitive indicators are. These are patient care elements that are directly impacted by nursing practice. They usually reflect three aspects of nursing care: structure, process, and outcomes.

For this video tutorial, I will address hospital readmission rates. Readmission rates are used to assess the quality of care provided in the inpatient unit. It is vital to monitor this indicator because high readmission rates are associated with poor quality of care, while low readmission rates are associated with high quality of care. Thus, the quality of care nurses provide can be assessed by monitoring the unit readmission rates (Rammohan et al., 2023).

As new nurses, you will need to familiarize yourselves with the quality indicator on readmission rates. This is because a high readmission rate may suggest that the nurses did not effectively implement measures to improve patients’ outcomes after discharge, such as providing appropriate health education and assessing patients’ understanding of self-care interventions (Rammohan et al., 2023). Besides, it would also indicate that the nurses failed to identify patients’ post-acute care needs, follow up with them post-discharge, and collaborate with their primary caregivers. On the other hand, a low readmission rate often indicates that the nurses assessed patients’ post-acute care needs and provided crucial discharge education.

Collection and Distribution of Quality Indicator Data

I interviewed a professional colleague who is well-versed in quality monitoring in the organization and is knowledgeable on how technology can help to collect and report patient readmission rates data. The interviewee explained that readmission rates in the organization include patients readmitted to a hospital within 30 days of discharge from a previous hospital stay. I learned that the organization’s readmission data is collected from multiple sources, including the electronic medical record (EMR), patient self-report, the State Health Information Exchanges (HIEs), and insurance databases. The EMR has been a great tool in providing healthcare providers with information on the last admission, including date of admission and discharge, diagnoses during the previous admission, treatment interventions provided, and discharge instructions and education (Daddato et al., 2019). The EMR usually has a discharge summary, which the providers use to record this vital information. Furthermore, the EMR was identified as the most reliable data source.

Patients provide information on previous admissions, which helps to establish the readmission rates. During each patient’s admission in the inpatient units, the admitting clinician must ask about their previous admissions in history taking and the cause of admission. However, patients are unreliable sources of information since some do not remember when they were discharged or are unaware of the diagnosis during admission (Daddato et al., 2019).

The State electronic HIE allows physicians, nurses, pharmacists, and other healthcare providers to appropriately access and securely share patients’ vital health information electronically. This helps to improve the speed, quality, safety, and cost of patient care. Our organization uses the Directed Exchange to quickly and securely send and receive patient information directly to other healthcare professionals and hospitals (Daddato et al., 2019). The HIE is usually valuable in cases where a patient has been admitted to another facility and cannot remember the cause of admission and date of discharge. Lastly, insurance databases are vital data sources since they contain information on when the patient was last admitted and the diagnoses.

How does the organization disseminate aggregate data?

The interviewee mentioned that the quality assurance department is responsible for disseminating aggregate data on readmission rates to the hospital units and the management team. The department organizes meetings with various units, like Pediatric or Medical-surgical units, to share the data on the readmission rates in the respective units. In these meetings, the quality assurance team discusses measures to lower readmission rates with the interdisciplinary teams in the units. The team also inquires from the providers on the possible causes of the increased readmission rates and the areas they think should be improved to lower the rates. Furthermore, the quality assurance department presents the readmission data using graphic presentations that help the team understand the trend of readmissions over time.

What role do nurses play in supporting accurate reporting and high-quality results?

We, as nurses, have a key role in supporting accurate reporting of readmission rates. Firstly, we need to be keen and ensure we take accurate patient history with information on readmission. In addition, we need to ensure that the discharge summary in the EMR is accurately documented by the physicians when discharging patients (Pugh et al., 2021). For patients who are unreliable historians, you should follow up with the informatics team to access data using the State electronic HIE.

References

Daddato, A. E., Dollar, B., Lum, H. D., Burke, R. E., & Boxer, R. S. (2019). Identifying Patient Readmissions: Are Our Data Sources Misleading? Journal of the American Medical Directors Association, 20(8), 1042–1044. https://doi.org/10.1016/j.jamda.2019.04.028

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing‐sensitive indicators for nursing care: A systematic review (1997–2017). Nursing Open, 8(3), 1005–1022. https://doi.org/10.1002/nop2.654

Pugh, J., Penney, L. S., Noël, P. H., Neller, S., Mader, M., Finley, E. P., Lanham, H. J., & Leykum, L. (2021). Evidence-based processes to prevent readmissions: more is better, a ten-site observational study. BMC health services research, 21(1), 189. https://doi.org/10.1186/s12913-021-06193-x

Rammohan, R., Joy, M., Magam, S. G., Natt, D., Patel, A., Akande, O., Yost, R. M., Bunting, S., Anand, P., & Mustacchia, P. (2023). The Path to Sustainable Healthcare: Implementing Care Transition Teams to Mitigate Hospital Readmissions and Improve Patient Outcomes. Cureus, 15(5), e39022. https://doi.org/10.7759/cureus.39022

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4040 Assessment 4 Instructions

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.

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:

• 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.
    • Health care-associated infections.
      • Catheter-associated urinary tract infection.
      • Central line catheter associated blood stream 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 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.

Transcript of Example Video

“Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI – to enhance quality care outcomes, improve training procedures, establish best practices, and improve patient satisfaction. These indicators also help in workflow and the recruitment and retention of quality staff. You play an important part of this. You are our eyes and ears when it comes to safe evidence-based practice and reporting data to help evaluate our Nursing Sensitive Quality Indicators.

We are very fortunate to be one of the 1100 facilities in the United States providing the data to NDNQI to fulfill nursing’s commitment to advancing our knowledge base to evaluate and improve patient care. The NDNQI is a national nursing database evaluating nursing care that provides annual and quarterly reporting of three major indicators which evaluate nursing care. In 2018, the authors Griggs, Wiechula & Cusack described those indicators as structure (staff/skill competency), process (patient assessment, nursing intervention, and job satisfaction) and outcome of patient care related to the quantity or quality nursing care. NDNQI is managed by a company named Press Ganey. Press Ganey sends us surveys for the data needed and then provides participating facility research driven reports with statistics and data themes. Multiple authors including Smith (writing in 2018) and Griggs, Wiechula & Cusack point out that this data allows us to understand what we are doing well in our facility and what we need to improve on, in comparison to national data, to enhance patient safety, patient care outcomes, and organizational performance reports.

Now I’d like to share an example, Our Chief Nursing Officer used the NDNQI ratios and acuity data on staffing to validate the need various levels of nurse staffing. Authors Mangold and Pearson, writing 2017, identify how this type of data can contribute to significant changes to our staffing matrix and ratios because of the data produced by nurses like you. Our nurses are better able to provide quality care as a result of this information and our patient satisfaction scores have almost doubled over that past 6 months.

Imagine a small snowball made of 5 pieces of snow, then imagine one made of 100 pieces of snow, and one made of 1100 pieces of snow…the greater the number the bigger the impact. If you were in the snowball fight, do you want the snowball made with five snowflakes or the one made with 1100 snowflakes? The same is true of the data in the NDNQI, when one facility implements a change the data from the change is shared with everyone through NDNQI so the dissemination of information is relatively quick and provides real time evaluation data.

For another example, over the past few months, we have experienced a dramatic rise in catheter-acquired urinary tract infections also known as CAUTIs and Hospital Acquired Conditions throughout the facility. This has dramatically affected the quality of patient care and ultimately our Press Ganey patient satisfaction surveys. Our rate of CAUTIs and Hospital Acquired Conditions have also impacted our rate of Medicare reimbursement. We have experienced a 1 percent reduction in reimbursement related to this CAUTI and associated HAC increase. Porter (2018) estimates CAUTI costs to be over $10,000. To give this number a little more impact, the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative reported in 2015 that there was a total of $330 million dollars lost in Hospital Acquired Conditions penalties across 721 facilities.

Our nurses have identified CAUTI in their patients with indwelling catheters as a concern as well as other Hospital Acquired Conditions. Recognizing that they are the first line of defense for patient safety, our nurses are participating in a hospital wide Acquired Condition Reduction Program modeled after the Centers for Medicare and Medicaid services (n.d). Our initiative looks at all infections acquired during treatment in this facility. I encourage you to look at this website. As a nurse you are the leader of healthcare quality, we depend upon you as the expert in patient care. YOU are extremely powerful in contributing to patient care in not only preventing CAUTIs but in providing a timely reporting of needed data in the Press Ganey surveys so that our data is contributed to NDNQI.

You May Ask… How Can I Help?

Nurses have an essential role within the interdisciplinary healthcare team. They are responsible for collecting and reporting data for the NDNQI. The data collected will contribute to improved outcomes, improved patient safety, and an overall improved patient experience. In our facility we provide the data using online surveys received from Press Ganey, all members of the interdisciplinary healthcare team receive the surveys. In a personal communication, our Chief Nursing Officer, Dr. Smith, underscored that the current facility best practice is to check your hospital email every day you work and complete any surveys sent to you. The data is very easy to enter into the survey. Dr. Smith stated that in the beginning there was a lot of lag time between data entry by the interdisciplinary team and the time the survey was sent out but that has improved. We have a quality team at the hospital responsible for supplying the general data related to CAUTIs. Other data provided to Press Ganey includes incident reports, patient admission dates, length or stay, readmission data, number of patients with catheters vs patients with CAUTIs diagnosed in facility vs after discharge. To learn more about Press Ganey please go to their website.

Your job as a nurse is to provide care according to the current practice policies, complete all required documentation which includes all popups on CAUTIs and then to enter data when emailed a survey from Press Ganey. Your role is incredibly powerful in this initiative because as you know we have a huge amount of responsibility in placing, caring for and assessing indwelling catheters and straight caths. Imagine if your work in completing all required documentation and some quick online surveys prevents future CAUTIs, the impact would be huge!

I would now like to discuss what we do WITH THE DATA

The data you provide, and which is found in the patient records provides insights into how the nursing care and interventions we provide influence patient outcomes. The data found within the NDNQI gives healthcare leaders an understand of what actions influence quality and patient safety. Within the NDNQI the data is trended and the themes and or statistical information is pulled out to help guide safety and quality initiatives.

Within this organization we have quality improvement teams on each unit where data from NDNQI and plans for improving quality are shared. We use the data for guiding us in creating quality improvement plans and ensuring patient safety. Quality improvement teams on your unit will share updates with the NDNQI data and how we plan to use the data.

As we wrap up I’d like to share some ideas about how your actions IMPACT HEALTH CARE IN GENERAL

Your involvement in accurate charting and completing surveys provides data used for the greater science of nursing. This information helps the nursing profession to identify nurse-sensitive indicators of quality to use for improvement in our patient care. Our nursing leaders use the NDNQI data to determine the best practices for their unit and facility to improve both quality care outcomes and workplace safety, including nurse patient staffing ratios.

Our facility models itself after the 2015 Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative Policy Brief for not only quality and safety improvement, but to achieve higher outcome-based hospital payments. Our Value Based Purchasing program provides acute care facilities incentive money when the facility has good performance on quality measurements and makes improvements in the facilities quality and safety of care. There is also an overlap of the Value Based Purchasing program and the Medicare reimbursement program so facilities are able to potentially have double the financial benefit because the nurse sensitive outcomes influence the requirements for full reimbursement from Medicare. John Hopkin’s hospital has been a leader in using the NDNQI data to make improvements in safety and quality with a 41% reduction in CAUTIs with the use of national data on nursing interventions from NDNQI. Nursing leaders need to work to ensure they use the data from the nursing sensitive outcomes to make improvements in care within individual facilities and units.

In CONCLUSION

Our involvement in NDNQI is a wonderful and positive influence on the profession of nursing and patient care. Your responsibility is to ensure you have accurate and complete documentation and to complete any Press Ganey surveys you receive. Our role as a facility is to provide all additional data to NDNQI and to support you in your work while focusing on quality improvement and sharing data with you from NDNQI and our quality improvement work. The success of NDNQI is relying on our commitment to provide data in a timely manner and then to use the national data to make improvements at the facility. Nurses are at the front line of quality improvement and evidence-based practice. We can all make a huge improvement in patient care. You are a valuable asset to our team!

Thank you!”

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 Kalturafor 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 Kalturafor 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.eduto 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 APApage on Campus.

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.

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Informatics and Nursing-Sensitive Quality Indicators Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.	Does not describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.	Begins to identify but does not describe the interdisciplinary team’s role in collecting and reporting quality indicator data.	Describes the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.	Describes in a professional manner the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports. Offers valuable insight into the impact of the interdisciplinary team on data collection.
Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.	Does not explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.	Attempts to explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.	Explains how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.	Provides a comprehensive, professional, and academic explanation for how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
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.	Does not 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.	Describes but does not 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.	Justifies 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.	Provides a comprehensive and scholarly justification for 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.
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.	Does not deliver an audio or a video tutorial with a script or speaker’s notes on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.	Provides a script or speaker’s notes of a tutorial without audio or video on a selected quality indicator, or the tutorial lacks purpose, coherence, or focus or has technical issues that distract from the presentation.	Delivers a professional and effective audio or video tutorial along with speaker notes on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion. Submission includes a reference list with at least three scholarly references.	Delivers a polished, professional, and effective audio or video tutorial along with speaker notes on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion. Audio or video presentation is appropriate for the audience. Submission includes a reference list with at least three scholarly references.
Follow APA style and formatting guidelines for citations and references.	Does not follow APA style and formatting guidelines for citations and references.	Partially follows APA style and formatting guidelines for citations and references.	Follows APA style and formatting guidelines for citations and references. Academic citations and references are largely error-free.	Follows APA style and formatting guidelines for citations and references with flawless precision and accuracy.