Informatics and Nursing-Sensitive Quality Indicators Essay

Informatics and Nursing-Sensitive Quality Indicators Essay

 

Informatics and Nursing-Sensitive Quality Indicators audio script

Hello. I welcome you to my audio presentation on nursing and quality. My name is           and I am a nurse at            . In this audio presentation, I will describe nursing-sensitive quality indicators and the National Database of Nursing-Sensitive Quality Indicators. I will also describe the process of collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports in our healthcare organization. You will get to understand your role in the process and why an interdisciplinary team’s input is also vital to the success of this process. Lastly, you will understand how our healthcare organization uses nursing-sensitive quality indicators.

Introduction to National Database of Nursing-Sensitive Quality Indicators

Before I describe the National Database of Nursing-Sensitive Quality Indicators, I will introduce you to what Nursing-Sensitive Quality Indicators are. A recent journal article by Afaneh et al. in 2021 defined nursing-sensitive quality indicators and reviewed recent literature on the concept of NSQIs and their implications in current practice. Nursing-Sensitive Quality Indicators, also known as NSQIs, are a set of performance measures and outcomes that are directly or indirectly affected by nursing and thus reflect the impact of nursing care on the patients’ health. It is possible to use these indicators to establish a common ground for benchmarking and to provide evidence of the cost-effectiveness of nursing care in order to establish a benchmarking plan.

In 1988, the American Nurses Association set up a database that collected, analyzed and reported specific indicators. This database was called The National Database of Nursing Quality Indicators ^TM (NDNQI®). This database is headquartered at the University of Kansas Medical Center (KUMC) School of Nursing. The purpose of this database was to improve patient safety and care quality through scientific and evidence-based decision-making. Since then, there has been an increase in the use of NSQIs in healthcare as a means of measuring the impact of nursing care on patient outcomes. In addition, it helps to identify best practices across different healthcare facilities by allowing for comparison of nursing care. Nursing leadership can also use NSQIs as a tool for allocating resources, making decisions and making decisions that improve the quality of care based on this information. These indicators include various staff measures and quality measures. NSQIs are used to evaluate the quality of nursing care and to identify areas for improvement. For this audio presentation, I selected pressure ulcer incidence rates as the NSQI.

Pressure ulcers are localized areas of damage to the skin caused by unrelieved pressure on an area of the body. Pressure ulcer incidence rates represent the new number of cases of patients with pressure ulcers, also known as bedsores, in some care settings. Knowing the new number of cases of bedsores is crucial because it reflects the quality of nursing care that patients receive in our healthcare organization. According to the Agency for Health Care Research and Quality website, the United States has more than 2.5 million pressure ulcers each year. These skin lesions cause pain, infection, and increased healthcare use. Therefore, this indicator is vital in improving the quality and safety of the nursing care that patients receive in the hospital. New nurses need to be familiar with this particular quality indicator when providing patient care. This is important because every admitted patient is at risk of developing pressure sores and ulcers when under your care, and it is your ethical and professional responsibility to protect your patients from preventable harm.

Collection and Distribution of Quality Indicator Data

Data on NSQIs is collected using a variety of methods, such as electronic medical records, patient surveys, and direct observation of the patient. This data is analyzed, and the results are used to identify improvements to be made, as well as to track the progress of the patient over time. I had an interview with the nurse informaticist, who is our institution’s NDNQI site coordinator. The site coordinator periodically consolidates and reports the NSQI data to the NDNQI databases and disseminates this feedback to the hospital and various institutions. Therefore, nurse leaders and hospital administrators can use this data to make administrative decisions and policies, while direct clinical care providers can improve their care standards using these reports. Data on the incidence rates of pressure ulcers are collected through our electronic health record system, which detects entry of pressure ulcers from nurses, doctors, and other healthcare providers in the hospital, such as physician assistants. Therefore, it is important to enter accurate data when building health histories for patients.

Nurses play an important role in documenting patient data during the collection and reporting of quality health indicators. Your participation in quality improvement begins with documentation of the new cases of pressure ulcers in the patient’s electronic medical record. To improve patient safety and quality regarding this particular indicator, it would be helpful to have accurate reporting to implement evidence-based quality improvement initiatives. This also calls for interdisciplinary team input because the prevention of pressure sores requires multidisciplinary approaches. Nurses will need to collaborate with doctors and other healthcare providers to implement and evaluate various strategies based on the latest evidence to improve patients’ health. According to Sullivan et al. (2023), a number of nursing specialties and general nursing practices are represented by established NSIs.

Overall, the pressure ulcer incidence rate is just of the many indicators that nurses need to participate in reporting and evaluating to provide safe care. As your patient’s advocate, it is your ethical call to ensure they get safe care. Therefore, a good nurse will participate in assessing, evaluating, and applying nursing-sensitive quality indicators. Thank you for listening. Until next time, Goodbye!

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References

Afaneh, T., Abu-Moghli, F., & Ahmad, M. (2021). Nursing-sensitive indicators: a concept analysis. Nursing Management (Harrow, London, England: 1994), 28(3), 28–33. https://doi.org/10.7748/nm.2021.e1982

Agency for Health Care Research and Quality. (n.d.). Preventing Pressure Ulcers in Hospitals. Ahrq.gov. Retrieved January 29, 2023, from https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/index.html

Sullivan, C. E., Day, S. W., Ivankova, N., Markaki, A., Patrician, P. A., & Landier, W. (2023). Establishing nursing-sensitive quality indicators for pediatric oncology: An international mixed methods Delphi study. Journal of Nursing Scholarship, 55(1), 388–400. https://doi.org/10.1111/jnu.12798

 

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 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.

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 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.

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.
• 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.

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.

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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.
• 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.