NURS 4040 Assessment 4: Informatics and Nursing Sensitive Quality Indicators  Paper

NURS 4040 Assessment 4: Informatics and Nursing Sensitive Quality Indicators  Paper

Informatics and Nursing Sensitive Quality Indicators

Hello everyone, welcome to this engagement session; my name is (enter your name here). This training session’s primary aim is to familiarize you with nursing-sensitive quality indicators, the National Database of Nursing Quality Indicators (NDNQI) role, and nurses’ role in supporting accurate reporting and high-quality results. I hope you will understand all these concepts by the end of this session.

What is the National Database of Nursing Quality Indicators (NDNQI)?

The national database of nursing Quality Indicators (NDNQI) is an American database that provides quarterly and annual reports about nursing quality indicators alongside conducting systematic data collection or nursing indicators for performance measurements at the national level. Also, the NDNQI compares the performance of more than 1100 US health organizations at the unit level. Finally, this national database provides operative measures to address various indicators, including pressure ulcers, falls, staff mix measures, job satisfaction, selective nosocomial infection, and human resource management issues.

What are nursing-sensitive indicators?

Barchielli et al. (2022) define nursing-sensitive quality indicators (NSI) as “those indicators that capture care or its outcomes most affected by nursing care” (p. 2). In this sense, they focus on nursing processes, outcomes, and structures consistent with Donabedian’s classification. Nursing-sensitive quality indicators include the prevalence of pressure ulcers; patient falls, nursing education level and skills, hospital structure and setting, nurse-to-patient ratios, and pain management approaches. Also, NSI encompasses human resource management aspects like job satisfaction, turnover, and burnout.

The selected quality indicator

Pressure ulcer prevalence is one of the quality measures that prompt healthcare professionals to implement evidence-based and patient-centered care. According to Ebi et al. (2019), pressure ulcers are preventable medical complications associated with immobility and lengthy hospitalization. The risk factors for pressure ulcers are incontinence, inadequate nutrition and hydration, advanced age, immobility, and device-related skin pressure. Getie et al. (2020) contend that pressure ulcers are preventable if healthcare professionals apply appropriate Measures, including enhancing patients’ mobility, monitoring and modifying the environment, shifting the patient’s weight frequently, ensuring sufficient nutrition and hydration, and improving patients’ comfort and dignity.

Why it is essential to monitor this quality indicator.

Frequent monitoring of pressure ulcer prevalence is essential in informing prevention interventions and improving outcomes. According to Getie et al. (2020), pressure ulcers occur due to the shortage of supplies for pressure ulcers, time pressure, insufficient knowledge of evidence-based preventive measures, and job dissatisfaction. As a result, it is essential to track the hospital’s performance on this quality indicator to identify the root causes, establish performance benchmarks and targets, and develop evidence-based approaches for preventing pressure ulcers and their effects, including deaths, prolonged hospitalization, and increased care costs.

Why do new nurses need to familiarize themselves with this quality indicator when providing care?

As you transition from nursing students to healthcare professionals, you will encounter a high prevalence of pressure ulcers and their subsequent ramifications. Our organization has established measures to prevent pressure ulcers. A contingency plan entails hourly rounds, enhancing patients’ mobility, modifying the environment to address risk factors, educating patients on effective strategies for reporting incidences of pressure ulcers, and using bedside technologies to alert clinicians to patients’ discomfort. As new nurses, you must familiarize yourself with these interventions, understand your roles, and work in teams to address this problem. By familiarizing yourself with this quality indicator, you will assist the organization in implementing and sustaining intervention plans for change and quality improvement.

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Organizational Strategies for Collecting and Distributing Quality Indicator Data

Strategies for disseminating aggregate data in our organization

During an interview with our organization’s chief nursing informaticist, he revealed that our organization has various strategies for collecting and disseminating data. One of these strategies includes using an electronic health record system (EHRS) to store, share, and retrieve information regarding nursing care processes and interventions to improve quality indicators. Secondly, nurses are responsible for utilizing patient health records and collecting first-hand qualitative and quantitative data from patients. Data from patients entail response to care processes, self-reported incidences of pressure ulcers, diagnoses, and response to medications. After collecting data and recording it on the electronic health record system, nurse informaticists facilitate its visualization by integrating it into hospital dashboards. Helminski et al. (2022) contend that hospital dashboards analyze and present information regarding performance metrics, allowing clinicians to visualize actionable data and optimize organizational performance.

Besides using hospital dashboards to visualize and disseminate data, the hospital relies massively upon clinical reports, journal publications, posters, pamphlets, and guidelines as primary approaches for disseminating information on quality improvement indicators and interventions for enhancing care quality. However, the Chief Nursing Informaticist unearthed various challenges that compromise the culture of effective data collection and dissemination. These challenges include time pressure, increased workload, burnout, and functionality issues of the electronic health record system (EHRS).

The role of nurses in supporting accurate reporting and high-quality results

Nurses understand the intricacies and demands of the current healthcare systems by developing meaningful relationships with patients and providing direct care. These close relationships involve gathering patient information and leveraging informatics to improve care quality and outcomes. According to Kennedy et al. (2017), nurses are responsible for using information regarding a patient’s history and current condition through physical assessments and laboratory tests. To support data accuracy, high-quality results, and effective reporting, nurses should understand the functionality of the electronic health record system, take adequate time to record and report information, and enhance communication with patients to obtain reliable and credible data.

Conclusion

As you join our team, remember that you have an ethical and professional obligation to benefit patients, prevent harm, uphold their values and preferences, and ensure justice in care delivery. As a result, I am convinced that everyone understands the role of the National Database of Nursing Sensitive Quality Indicators, nursing sensitive indicators, and the role of nurses in supporting accurate reporting and high-quality results. As we move forward, I endeavor to assist you in understanding quality improvement indicators that form the basis of organizational processes, outcomes, and structures. Thank you very much for your time.

References

Barchielli, C., Rafferty, A. M., & Vainieri, M. (2022). Integrating key nursing measures into a comprehensive healthcare performance management system: A Tuscan experience. International Journal of Environmental Research and Public Health, 19(3), 1–14. https://doi.org/10.3390/ijerph19031373

Ebi, W. E., Hirko, G. F., & Mijena, D. A. (2019). Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: A cross-sectional study design. BMC Nursing, 18(1). https://doi.org/10.1186/s12912-019-0346-y

Getie, A., Baylie, A., Bante, A., Geda, B., & Mesfin, F. (2020). Pressure ulcer prevention practices and associated factors among nurses in public hospitals of Harari regional state and Dire Dawa city administration, Eastern Ethiopia. PLOS ONE, 15(12), e0243875. https://doi.org/10.1371/journal.pone.0243875

Helminski, D., Kurlander, J. E., Renji, A. D., Sussman, J. B., Pfeiffer, P. N., Conte, M. L., Gadabu, O. J., Kokaly, A. N., Goldberg, R., Ranusch, A., Damschroder, L. J., & Landis-Lewis, Z. (2022). Dashboards in health care settings: Protocol for a scoping review. JMIR Research Protocols, 11(3), e34894. https://doi.org/10.2196/34894

Kennedy, B., Dietrich, M., Mion, L., Novak, L., & Jeffery, A. (2017). A qualitative exploration of nurses’ information-gathering behaviors prior to decision support tool design. Applied Clinical Informatics, 08(03), 763–778. https://doi.org/10.4338/aci-2017-02-ra-0033

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

Introduction
As you begin to prepare this assessment you are encouraged to complete the Conabedian 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.

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.

The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.

Reference
Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.

Preparation
This assessment requires you to prepare an 8–10 minute audio training 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:

Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system. Choose from the following list:
Staffing measures.
Nursing hours per patient day.
RN education/certification.
Skill mix.
Nurse turnover.
Nursing care hours in emergency departments, perioperative units, and perinatal units.
Skill mix in emergency departments, perioperative units, and perinatal units.
Quality measures.
Patient falls.
Patient falls with injury.
Pressure ulcer prevalence.
Health care-associated infections.
Catheter-associated urinary tract infection.
Central line catheter associated blood stream infection.
Ventilator-associated pneumonia.
Ventilator- associated events.
Psychiatric physical/sexual assault rate.
Restraint prevalence.
Pediatric peripheral intravenous infiltration rate.
Pediatric pain assessment, intervention, reassessment (air) cycle.
Falls in ambulatory settings.
Pressure ulcer incidence rates from electronic health records.
Hospital readmission rates.
RN satisfaction survey options.
Job satisfaction scales.
Job satisfaction scales – short form.
Practice environment scale.

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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?
Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar.
Recording Your Presentation
To prepare to record the audio for your presentation, complete the following:

Set up and test your microphone or headset 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 quality is sufficient.
Review the 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.
Notes:

You may use other tools to record your tutorial. You will, however, need to consult Using Kaltura for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.
You may also choose to create a video of your tutorial, but this is not required.
If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations.
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?
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.
After completing your script, practice delivering your tutorial several times before recording it.

Additional Requirements
Audio communication: Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Length: 8–10 minute audio recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.
Script: A separate document with the script or speaker\’s notes is required. Important: Submissions that do not include the script or speaker\’s notes will be returned as a non-performance.
References: Cite a minimum of three scholarly and/or authoritative sources.
APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

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.
Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.
Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
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.
Justify 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.
Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Follow APA style and formatting guidelines for citations and references.