NURS 8302 Discussion Quality Indicators
Quality of nursing care is important because it is directly linked to patient safety, satisfaction, and other care outcomes. However, the assessment of the quality of care has several challenges. Educating nurses on quality indicators leads to positive patient outcomes (Mangold & Pearson, 2017). The quality improvement council ensures that nurses receive training on the importance of nursing-sensitive quality indicators. New nurses are normally trained to help them gain knowledge in this particular area. This is a tutorial script providing an in-depth discussion about nursing-sensitive quality indicators.
What is the NDNQI®?
The National Database of Nursing Quality Indicators (NDNQI®) is a national nursing database that measures structure, process, and outcome indicators to enhance evaluation of nursing care (Garrard, Boyle, Simon, Dunton, & Gajewski, 2016). The American Nurses Association (ANA) established the NDNQI® in 1998 to collect and build on data obtained from earlier studies to promote knowledge about factors influencing the quality of nursing care. The NDNQI® database is managed at the University of Kansas Medical Center (KUMC) School of Nursing under contract to ANA.
What are Nursing-Sensitive Quality Indicators?
Three types of nursing-sensitive quality indicators include structure, process, and outcome of nursing care. Structural indicators include the supply of nursing staff, the skill level of nurses, and certification and education levels of nursing staff (Mangold & Pearson, 2017). Process indicators include the method of patient assessment and nursing interventions. Similarly, outcome indicators are patient outcomes such as pressure ulcers, falls, and others.
Selected Quality Indicator
The selected quality indicator selected for this paper is the prevalence of hospital-acquired pressure ulcers. A pressure ulcer is an injury of the skin or underlying tissue due to friction, moisture, and pressure. They are prevalent among patients with reduced mobility including those who can’t change their position in bed on their own (Bhattacharya & Mishra, 2015). A high prevalence of pressure ulcers in a healthcare facility indicates low-quality nursing care. Quality improvement strategies should be devised to avert the situation. Hospital-acquired pressure ulcers are NDNQI® quality indicators.
Why is this Quality Indicator Important to Monitor?
Monitoring pressure ulcers is necessary because they have an adverse impact on the health of patients. They occur when nursing care is not being practiced to a full extent. Early recognition of pressure ulcers reduces the complexity and the severity of the illness (Bhattacharya & Mishra, 2015). Only through regular monitoring can the disease be prevented, identified early, and managed effectively. Additionally, other causes of pressure ulcers include mobility issues, changes in cognitive, bladders or bowel functions, and insufficient intake of liquids.
The Impact of This Indicator on the Quality of Care and Patient Safety.
Pressure ulcers impact negatively on the quality of care and patient safety. The illness can damage the skin and muscles, slow patients’ recovery process, and cause more pain. Patients with this condition have indicated delayed recovery compared to the general population leading to longer lengths of hospital stay (Boyko, Longaker, & Yang, 2018). Furthermore, the quality indicator may lead to other infections and more healthcare problems. In some countries, such conditions are not covered by insurance organizations, therefore, they are associated with the increased cost of care. Pressure ulcers must be treated quickly to avoid these problems to improve the quality of care and patient outcome.
Why New Nurses Need to Be Familiar with This Particular Quality Indicator
One of the ways of improving the quality of care is to educate new nurses about pressure ulcers. Education will help them acquire the necessary knowledge regarding the influences the quality indicator has on patients and how to prevent it from occurring (Bhattacharya & Mishra, 2015). Furthermore, they will gain skills about many several preventive measures for pressure ulcers such as the provision of good skincare, assessing patients to change position in bed regularly, and using a pressure reducing mattresses and cushions. Best practices among the new nurses will result in reduced cases of pressure ulcers. New nurses have limited experience in their nursing practice and in working with individuals having mobility problems. Patients cared for by the new nurses may suffer from pressure ulcers (Boyko et al., 2018). This argument makes it relevant to educate them regarding quality indicators including pressure ulcers.
Collection and Distribution of Quality Indicator Data
Quarterly pressure ulcer prevalence study days are normally conducted within the organization. Every hospitalized patient is assessed to determine the presence of pressure ulcers. The percentage of patients with hospital-acquired pressure ulcers id determined by diving the number of patients with the condition by the total number of all patients examined during these days to determine (Bhattacharya & Mishra, 2015). The results of these analyses are used to perform a statistical comparison to see if there is an improvement. The data is used to rank the organizational performance against others. Comparisons are also done between the organizational departments. The pressure ulcer quality control teams collect the data by walking from bed to bed to assess all the patients.
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The information and data about pressure ulcers are distributed across all the departments as well as between the interdisciplinary teams. The organization uses electronic health record which has different features and interfaces for distributing data to all providers including nurses and physicians (Demin et al., 2017). The primary goal of the healthcare organization is to ensure that data is available to all decision-makers. Other methods of data distribution include email, and texts. Furthermore, the organization submits the data to the NDNQI, through the electronic health information system, to see how it compares to other organizations within the region.
Nursing informaticists have a special role in obtaining accurate and high-quality data within the healthcare organization. Informatics nurses provide education to fellow nurses and other professionals regarding data entry and health information technology usage. They often work together with the information technology department to ensure effective and accurate data transmission to all providers (Demin et al., 2017). One of the roles of the informaticist is the accurate entering of data into the system as indicated in the original papers.
Accurate data regarding pressure ulcers may provide an insight into how the organization is performing in terms of nursing care. The data can be used by the decision-makers to determine areas or aspects of care that need to be improved (Bhattacharya & Mishra, 2015). Accurate data provides insight as to whether or not the nursing intervention works. Sometimes the nursing interventions might be changed if they fail to produce desired outcomes. For instance, accurate records may indicate whether the incidences of pressure ulcers reduced after implementation of the quality improvement programs (Bhattacharya & Mishra, 2015). Also, only through accurate data can the healthcare leaders determine whether or not the measures put forward to prevent pressure ulcers worked ou.
Nursing care quality is important because it is connected to patient satisfaction, safety, and other care outcomes. NDNQI® is a national database that offers quarterly and annual reporting of structure, process, and outcome indicators. A pressure ulcer is a quality indicator that can have a bad influence on patients’ health. The nurse should learn about pressure ulcers to prevent them from occurring. Quality and accurate data are important to determine areas that need to be improved.
Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery, 48(01), 004-016. doi: 10.4103/0970-0358.155260
Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in wound care, 7(2), 57-67. doi: 10.1089/wound.2016.0697..
Demin, C., Xiaobo, L., & Yang, G. (2017, November). System design and development of distribution network planning quality indicator monitoring platform. In 2017 IEEE Conference on Energy Internet and Energy System Integration (EI2) (pp. 1-6). IEEE. doi:10.3390/en1004050
Garrard, L., Boyle, D. K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western journal of nursing research, 38(1), 111-128. doi: 10.1177/0193945914542851.
Mangold, K., & Pearson, J. (2017). Making Sense of Nursing-Sensitive Quality Indicators. Journal for nurses in professional development, 33(3), 159-160. https://www.nursingcenter.com/journalarticle?Article_ID=4126163&Journal_ID=54029&Issue_ID=4125744