Informatics and Nursing Sensitive Quality Indicators: Patient falls with injury

 

Patient falls with injury…….see example speech below. Include APA reference page with at least Intro instructions: 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. Instructions: 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? 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. EXAMPLE: “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 11​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​00 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

Sample Solution

ocial: Schools are adopting specific behaviours to improve outcomes for disadvantaged pupils, implementing community centered strategies for parent involvement, monitoring of progress and providing individual learning support; schools have systems in place for early identification and intervention. Pupil premium awarded to raise attainment and also different strategies are used to engage with the disadvantaged families to increase parental engagement and improve academic performance.

Technological: Smart apps and devices are fast and furious, schools are confronted with challenging issues from online risks such as violation of privacy or fraud, schools are expected to educate children by raising awareness about these risks and how to avoid them, however budget restrictions is causing to be a barrier on latest ICT equipment and software.

3.4 Explain how a range of analytical tools can be used to investigate & address key management issues within a school:

Using analytical tools widens the approach of thinking, enabling SBMs to solve a problem, be predictive and be implementable. I believe the aim of using analytical tools is to sharpen the focus of the analysis and to ensure methodical, balanced approach, e.g. SWOT- helps to focus on internal and external factors, which SBMs can use to identify issues as well as barriers and solutions, useful to spot danger and improve weakness. PESTLE tool can be used to analyse various external factors, which impact schools.

SWOT (Appendix 3) Increase parent engagement by holding quarterly workshops: analysis clearly indicates the benefits of this objective and it will add much value to the school. It has highlighted the budget strain for additional workshops but the opportunity highlighted a possible solution parent’s contribution, another weakness could be lack of staff, however PTA involvement can tackle this. The analyses tool has highlighted issues on both the internal and external factors and also solutions.

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