Informatics and Nursing-Sensitive Quality Indicators

 

Prepare an 8–10 minute audio training tutorial (video is optional) for new nurses on the importance of 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?

Sample Solution

Audio Tutorial Outline:

  1. Introduction (1 minute):
    • Welcome and introduction of yourself.
    • Briefly define NSQIs and their importance in nursing.
    • State the purpose of the tutorial: to educate new nurses on NSQIs and their role in quality improvement.
  2. NDNQI and Donabedian’s Framework (2 minutes):
    • Explain the background of the National Database of Nursing Quality Indicators (NDNQI®).
    • Introduce Avedis Donabedian’s structure, process, and outcome framework.
    • Explain how NDNQI® utilizes this framework.
  3. Focus on a Specific NSQI (3 minutes):
    • Select and introduce a specific NSQI (e.g., patient falls, pressure ulcers, central line-associated bloodstream infections).
    • Explain the importance of this specific indicator.
    • Discuss how nursing actions directly impact this indicator.
    • Share current research findings related to the chosen NSQI.
  4. Data Collection, Analysis, and Reporting (2 minutes):
    • Discuss the role of nurses in data collection and reporting.
    • Explain how technology is used to collect and analyze data.
    • Share insights from your professional interview regarding data collection challenges and reporting.
    • How is the data shared with the nursing staff?
  5. Quality Improvement and Evidence-Based Practice (1 minute):
    • Explain how NSQIs contribute to quality improvement initiatives.
    • Discuss the role of NSQIs in establishing evidence-based practice guidelines.
    • Reinforce the importance of nurses’ involvement in quality improvement.

Audio Tutorial Script (Example using Patient Falls as the NSQI):

(0:00-1:00) Introduction

“Hello, and welcome. My name is [Your Name], and I’m here today to talk to you about nursing-sensitive quality indicators, or NSQIs. These indicators are crucial for ensuring high-quality patient care and safety. NSQIs are specific measures that reflect the impact of nursing interventions. This tutorial will help you understand their importance and how you, as a new nurse, play a vital role in improving patient outcomes.”

(1:00-3:00) NDNQI and Donabedian’s Framework

“The American Nurses Association established the National Database of Nursing Quality Indicators, or NDNQI®, in 1998. It’s a national database that tracks and reports on quality indicators heavily influenced by nursing actions. This database provides a standardized way to evaluate nursing performance and compare it across hospitals. NDNQI® uses Avedis Donabedian’s framework, which categorizes quality indicators into three areas: structure, process, and outcome. Structure refers to the resources and organizational characteristics, process refers to the delivery of care, and outcome refers to the results of care. By monitoring these areas, we can identify areas for improvement and enhance patient safety.”

(3:00-6:00) Focus on Patient Falls

“Today, let’s focus on patient falls as our NSQI. Patient falls are a significant concern in healthcare, as they can lead to serious injuries and complications. Nursing interventions are critical in preventing falls. This includes conducting thorough risk assessments, implementing fall precautions, educating patients and families, and ensuring a safe environment. Research consistently shows that proactive nursing interventions, such as regular rounding, assistance with ambulation, and proper medication management, significantly reduce fall rates. For example, studies have shown that implementing a standardized fall prevention protocol can decrease fall rates by up to 30%.”

(6:00-8:00) Data Collection, Analysis, and Reporting

“Nurses play a crucial role in collecting data related to patient falls. This includes documenting fall incidents, completing risk assessments, and recording interventions. Technology, such as electronic health records and fall risk assessment tools, helps us collect and analyze this data efficiently. I interviewed [Colleague’s Title/Role] who mentioned that one of the biggest challenges is ensuring accurate and timely documentation. They emphasized the importance of training nurses on proper data entry and the significance of their contributions. My collegue also said that the quality improvement department shares the data with the nursing staff through monthly meetings and posted reports. This open communication allows nurses to see the impact of their work and identify areas for improvement.”

(8:00-9:00) Quality Improvement and Evidence-Based Practice

“NSQIs like patient falls contribute to quality improvement initiatives by providing data to identify trends and areas for intervention. By using this data, we can develop and implement evidence-based practice guidelines. For example, if we see a high rate of falls on a particular unit, we can investigate the causes and implement targeted interventions, such as increased staffing or improved lighting. Your involvement in data collection and quality improvement is essential to providing safe and effective patient care.”

(9:00-10:00) Conclusion

“Thank you for taking the time to learn about nursing-sensitive quality indicators. Remember, your actions as a nurse directly impact patient outcomes. By understanding and actively participating in quality improvement initiatives, you can help create a safer and more effective healthcare environment. Please remember to always document accuratly. Thank you.”

Tips for Recording:

  • Speak clearly and at a moderate pace.
  • Use a professional tone.
  • Minimize background noise.
  • If using video, ensure good lighting and a clean background.
  • Practice your script to ensure smooth delivery.

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