Informatics and Nursing Sensitive Quality Indicators

Informatics and Nursing Sensitive Quality Indicators

Nurses should always be skilled and prepared to provide quality care. However, many issues, including knowledge and situations, hamper nurses’ ability to provide quality care. When new nurses join health care organizations, awareness of the issues hampering care quality should be a priority. They should understand the connection between nursing practice and patient outcomes and their role in delivering the desired health outcomes. Accordingly, awareness of nursing-sensitive indicators is crucial for all nurses. The purpose of this tutorial is to describe the importance of nursing-sensitive indicators and the nurses’ role in accurate reporting and high-quality results.

National Database of Nursing-Sensitive Quality Indicators

Before examining nursing-sensitive indicators, it is crucial to examine the National Database of Nursing-Sensitive Quality Indicators (NDNQI), mainly focusing on its roles. According to Harding et al. (2019), the American Nursing Association established the NDNQI as a national database for providing timely and detailed reports on the unit-level effects of nursing. NDNQI provides quarterly and annual reports. Its mandate implies that NDNQI’s primary goal is to build a growing body of knowledge that describes the issues impacting the quality of nursing care. Such a database is vital since nursing must continuously assess and improve practice.

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Nursing-Sensitive Quality Indicators

At every level, nurses impact their patients significantly. However, the impacts cannot be accurately determined without accurate indicators. At the basic level, nursing-sensitive quality indicators reflect patient care elements that the nursing practice affects directly. According to Oner et al. (2021), nursing-sensitive quality indicators reflect three nursing care aspects: structure, process, and outcomes. In nursing practice, structural indicators have much to do with the supply of nursing staff and their skills. Education and certification levels of nurses are other structural indicators. Process indicators include methods that assess patients and nursing interventions. Outcome indicators reflect outcomes related to quality and quantity of care. Suitable examples include patient falls and pressure ulcers.

Nurse Turnover as a Nursing-Sensitive Quality Indicator

Nurse turnover is a staffing measure since it varies depending on the supply of nursing staff and job satisfaction levels. I have selected nurse turnover as the focus of this tutorial since all nurses can be victims of nurse turnover. Besides, new nurses are associated with high nurse turnover due to challenging work environments, workplace incivility, and the inability to cope with their job’s emotional and mental demands. Whether new or old in practice, the decision that a nurse makes has a profound impact on patient care. As a result, nurse turnover must be a priority area.

Before examining why it is crucial to monitor nurse turnover, it is vital to evaluate what nurse turnover entails and the underlying causes. It represents nurses leaving the job at any point, mainly when it is unexpected. Dewanto and Wardhani (2018) categorized the reasons for nurse turnover into three main groups: personal reasons, job offers from other organizations, and leaving due to working conditions. Personal reasons include issues such as age or joining other professions. The problem cannot be overlooked since the current nurse turnover in the United States ranges from 8.8% to 37% (Haddad et al., 2020). The rates vary depending on an organization’s location and nurses’ specialty.

Why it is Important to Monitor Nurse Turnover

At all times, nurses must be in the proper physical and mental state to provide patient care. Nurse turnover impedes nurses’ ability to work optimally since it increases the workload on nurses before they get a suitable replacement. Daouda et al. (2021) further mentioned that replacements do not always match the skills and experiences of the nurses that leave their job at a given time. Such challenges imply that patient care is affected adversely, an issue that nurses must always avoid. Worse, the increased workload may cause burnout, leading cause of burnout in nursing. Monitoring turnover is essential to facilitate replacement plans and ensure nurses are empowered to continue serving as expected.

The other reason for monitoring nurse turnover is its effects on health care costs. Currently, healthcare costs are high, and health care organizations should invent new ways of making health care affordable. However, it is challenging to achieve this objective when health care organizations spend substantial time and financial resources to deal with nurse turnover. Dewanto and Wardhani (2018) found that health care organizations spend massively recruiting and training nurses due to nurse turnover. Such resources could have been used in other programs such as nurse empowerment and purchasing health care technologies. Monitoring nurse turnover can help health care organizations to understand its dynamics and respond promptly.

Nurse turnover hampers the quality of care and patient safety. Overworked nurses cannot concentrate as naturally expected. Their productivity also declines as they lose concentration and interest on the job. Besides this adverse outcome, nurses are usually assigned specific patients depending on patients’ conditions, the intensity of care required, and special needs. Over time, nurses and patients form personal bonds that break when nurses leave an organization (Senek et al., 2020). The care process lacks continuity, and patients cannot receive patient-centered care. Such outcomes show the severity of nurse turnover and why it needs close monitoring.

Familiarity with Nurse Turnover

Knowledge is vital for new nurses to ensure that they are prepared and adequately skilled to cope with practice challenges. Accordingly, new nurses should understand nurse turnover and its implications on patient care. They should avoid issues fueling turnover as they help their colleagues cope with situations and adjust accordingly. Furthermore, new nurses should identify circumstances leading to turnover and ask for support to ensure that patient care is not adversely affected.

Collection and Distribution of Quality Indicator Data

Data is an integral part of today’s health practice. It is challenging to monitor trends and make accurate decisions without using data. When collecting data, nurses should consider technologies to enhance accuracy and promptness. However, new nurses cannot understand data collection and their role without interacting with experienced colleagues. From my interview with a colleague in the quality control department, my organization collects data on nurse turnover through a monthly analysis of staffing conditions. As the progressive reports also demonstrate, the monthly analysis compares the number of nurses who left the organization with those still working to quantify the turnover rate. In this analysis, unit managers provide the number of nurses who left and the causes. Next, the qualitative and quantitative summaries are handed over to the quality control department and the management to compose progressive reports. Such reports are detailed about the trends in nurse turnover, among other crucial data that guides the management and human resource department in decision-making regarding staff recruitment, training, and retention.

Data dissemination plays an instrumental role in creating an informed workforce. As an administrative practice, data dissemination helps nurses and other staff to understand the organizational performance on critical aspects of care (Shi, 2020). The organization disseminates aggregate data in two main ways. The first strategy is by sharing progressive performance reports. Here, departmental leaders and the management analyze how the units perform in terms of employee retention and whether any interventions are necessary based on the turnover rates. The other strategy includes briefs on the organization’s education page. Here, the staff is updated on the current developments, including nurse turnover and expected changes in the work schedules.

Regardless of their length of service, nurses play a crucial role in supporting accurate reporting and high-quality results. It is also a role that new nurses must embrace and be conversant with as they start actual practice. Firstly, nurses must provide timely updates on issues that affect the quality of care. Besides timely reporting, nurses must give an accurate report of any update as professionally required. In this case, nurses must enter the correct data in data collection systems and use technologies as necessary.


New nurses need to be ready to execute their mandate besides being adequately skilled. One way to achieve this goal is by being aware of nursing-sensitive quality indicators and their role in reporting and supporting high-quality results. As a concluding note, it is crucial to remember that nurse turnover can occur at any point in a nurse’s service. New nurses are also vulnerable to nurse turnover as they try coping with practice challenges and adapting to new environments. As a critical nursing-sensitive quality indicator, nurse turnover adversely affects patient safety and care quality. Besides being conversant with nurse turnover, nurses should help with accurate and timely data reporting to ensure high-quality results.



Daouda, O. S., Hocine, M. N., &Temime, L. (2021). Determinants of healthcare worker turnover in intensive care units: A micro-macro multilevel analysis. PloS One16(5), e0251779.

Dewanto, A., &Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing17(2), 1-7.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020).Nursing shortage. StatPearls [Internet].

Harding, M. M., Kwong, J., Roberts, D., Hagler, D., &Reinisch, C. (2019). Lewis’s medical-surgical nursing e-book: Assessment and management of clinical problems, single volume. Elsevier Health Sciences.

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 Open8(3), 1005-1022.

Senek, M., Robertson, S., Ryan, T., King, R., Wood, E., Taylor, B., &Tod, A. (2020). Determinants of nurse job dissatisfaction-findings from a cross-sectional survey analysis in the UK. BMC Nursing19(1), 1-10.

Shi, L. (2020). Novick& morrow’s public health administration.Jones & Bartlett Learning.

Prepare an 8-10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.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?
o 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?

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