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 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.
Preparation
As you begin to prepare this assessment you are encouraged to complete the Donabedian 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 narrated 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:
• Review the nursing-sensitive quality indicators presented in the Assessment 04 -: Informatics and Nursing Sensitive Quality Indicators [PDF] Download Assessment 04 -: Informatics and Nursing Sensitive Quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
• 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:
o What is your experience with collecting data and entering it into a database?
o What challenges have you experienced?
o How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
o 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?
Recording Your Presentation
To prepare to record your presentation, complete the following:
• Set up and test your microphone or headset and webcam 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 and video quality is sufficient.
• Review Using Kaltura 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.
• Practice presenting using PowerPoint, Keynote, Slides, Canva or another presentation platform.

 

For this assessment, first review the nursing-sensitive quality indicators presented in the Assessment 04 - Informatics and Nursing Sensitive Quality Indicators [PDF] Download Assessment 04 - Informatics and Nursing Sensitive Quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
Next, 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 prefers a recorded presentation using PowerPoint or a similar application. This will allow the education department to show the presentation during new hire training.
As a result of this need, you offer to create a presentation orienting new hires to these topics. You know that you will need speakers notes to guide your recording. You plan to incorporate 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 presentation:
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?
o As an example, consider the importance of accurately entering data regarding nursing interventions.
Enhancing Outcomes
• Explain how your health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
• Describe 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.

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• 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.
o Describe nursing-sensitive quality indicators in general and explain the importance of a selected indicator to the quality of care and patient safety.
o Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports, including the data that currently exists about a quality indicator.
• Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
o 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.
o Describe 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.

 

 

 

oday, we'll focus on an outcome indicator that's a top priority for our organization: falls with injury.

(Slide 4: Why is This Indicator Important?) Falls with injury are a critical patient safety concern. A fall can lead to a range of injuries, from minor bruises to life-threatening fractures and head injuries. It prolongs hospital stays, increases healthcare costs, and, most importantly, causes significant pain and distress for our patients. By monitoring and reducing falls with injury, we directly improve patient safety and enhance their care experience.

(Slide 5: Why New Nurses Need to Know This) As a new nurse, you are on the front line of fall prevention. Your knowledge of a patient's risk factors and your adherence to fall prevention protocols are the first and best line of defense. Every patient assessment, every rounding check, and every bit of patient education you provide directly impacts this metric.

 

Collection and Distribution of Quality Indicator Data

 

(Slide 6: How We Collect Data) According to my recent conversation with [Colleague's Name], a [Colleague's Title] in our organization, our data collection process for falls is a team effort. The primary data source is our Electronic Health Record (EHR). When a fall occurs, the nurse involved completes a detailed fall incident report within the EHR. This system, helps us capture essential information, such as the time of the fall, the patient's activity, and any resulting injuries.

(Slide 7: Data Dissemination) So, what happens to all that data? Once the information is entered, it's aggregated at the unit and organizational levels. Our Quality Improvement Council and nursing leadership regularly receive reports. For new hires, this is a key point: our organization is committed to transparency. We use dashboards and regular staff meetings to share our fall rates. We celebrate when our rates are low, and when they rise, we collaborate on solutions.

(Slide 8: The Nurse's Role in Accurate Reporting) This is where your role is absolutely vital. You are the source of the data!

Accurate Documentation: The information you enter into the EHR is what gets analyzed. Be meticulous in documenting every detail of a fall incident, including the patient's status, interventions in place, and the outcome. Inaccurate data entry can skew our reports and lead us down the wrong path when trying to find a solution.

Reporting Near Misses: Don’t just report the falls that cause injury. Report every fall. Reporting a "fall without injury" is just as important because it gives us insight into the circumstances that could have led to a more serious event.

Sample Answer

 

 

 

 

 

 

 

Introduction: Nursing-Sensitive Quality Indicators

 

(Slide 1: Title Slide) Title: The Power of Your Practice: Understanding Nursing-Sensitive Quality Indicators Presenter: [Your Name] Role: Member, Quality Improvement Council

(Slide 2: What is NDNQI®?) Hello, and welcome to the team! I'm here today to talk about something that's absolutely critical to our hospital's mission: quality and safety. You may have heard of the National Database of Nursing Quality Indicators, or NDNQI®. It was established by the American Nurses Association to create a standardized way to track nursing performance and its impact on patient outcomes. Think of it as a tool that helps us see how our daily actions at the bedside contribute to the bigger picture of quality care.

(Slide 3: What are Nursing-Sensitive Quality Indicators?) Nursing-sensitive quality indicators are measures that are heavily influenced by the quality and quantity of nursing care. They fall into three categories:

Structure: This is about the environment and resources, like the number of registered nurses per patient or the nursing skill mix.

Process: This refers to what nurses do, such as following a standardized fall prevention protocol.

Outcome: This is the result of that care, such as the rate of patient falls.

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