NURS-FPX4040 Assessment 4: Informatics and Nursing Sensitive Quality Indicators

Informatics and Nursing Sensitive Quality Indicators

Quality improvement teams and councils in healthcare settings work in collaboration with nurses to enhance quality initiatives based on the National Database of Nursing Quality Indicators (NDNQI) to determine the effects of nursing care on patient safety and outcomes. The National Database of Nursing Quality Indicators provides an annual and quarterly reports on structural, process, and outcome indicators to assess nursing care at unit levels (Evangelou et al., 2021). The purpose of this paper is to evaluate these indicators and their impacts in nursing units’ approaches to patient safety and outcomes.

National Database of Nursing-Sensitive Quality Indicators

The National Database of Nursing-Sensitive Quality Indicators (NDNQI) is a database by the American Nurses Association (ANA) which collects and evaluates specific nurse-sensitive information from facilities across the U.S. health system. The database contains data on patient quality and safety measures with the aim of improving care delivery through addressing the causative factors (Dzikowicz et al., 2021). The database allows providers, especially nurses and organizations to implement measures to reduce poor indicators and causes of undesirable outcomes in facilities across the industry.

Nursing-Sensitive Quality Indicators

Nursing quality-sensitive indicators entail quantifiable items that describe the effects of nursing care on patients. Based on the Donabedian model, these quality indicators can be structural, process or outcomes. Structural quality indicators provide insight into if systems, processes and care providers offer high quality care. structural quality measures comprise of nurse turnover, skill mix, and level of education and certification of registered nurses in a facility. The Outcome quality measures mirror the effects of nursing interventions on patient’s health (Ju et al., 2018). On their part, process quality measures indicate interventions that maintain or improve health. for instance, outcome quality measures comprise of catheter-associated urinary tract infections (CAUTIs) and ventilator-associated pneumonia. Process quality measures may include nurse satisfaction levels and patient care experience levels.

NURS-FPX4040 Assessment 4: Informatics and Nursing Sensitive Quality Indicators

Informatics and Nursing Sensitive Quality Indicators

The National Database of Nursing Quality Indicators (NDNQI) is a national nursing database that offers quarterly and annual reporting of process, structure, and outcome indicators to evaluate nursing care at the unit level (Oner et al., 2021). NDNQI gives healthcare organizations performance reports that facilitate hospital administrators in comparing their data with national percentile rankings, averages, and other essential information.

Nursing-Sensitive Indicators

Nursing-sensitive indicators are components of patient care directly impacted by nursing practice. Nursing-sensitive quality indicators represent three components of nursing care: process, structure, and outcomes (Oner et al., 2021). Process indicators examine patient assessment and nursing interventions methods. Structural indicators encompass nursing staff ratios, the skill level of nursing staff, and nurses’ education and certification (Oner et al., 2021). Outcome indicators represent patient outcomes regarded as nursing-sensitive because they are founded on the quantity and quality of nursing care.

Selected Quality Indicator

Catheter-associated urinary tract infection (CAUTI) is the quality indicator that I will address in this tutorial. CAUTI is a nosocomial urinary tract infection and the most common hospital-acquired infection accounting for 80% of all UTIs (Gomila et al., 2019). The high prevalence is because 15- 25% of admitted patients get catheterized at some point during their hospital stay. However, studies suggest that CAUTIs are highly preventable, and probably 50-70 percent of these episodes can be prevented (Gomila et al., 2019). The major risk factor for UTIs in the hospital setting is the temporary insertion of an indwelling urinary catheter. CAUTI develops when microbes are inoculated into the bladder by the urethral catheter (Gomila et al., 2019). This provides an environment for bacterial adhesion causing mucosal irritation. Individuals with the highest risk of developing CAUTI include: patients with prolonged periods of catheterization, microbe colonization of the drainage bag, faults in catheter care, catheterization late in the hospital course, and those not on antimicrobial therapy. 

Why iss CAUTI Important to Monitor?

It is crucial to monitor CAUTI because of its associated complications and recurrence. Complications of CAUTI range from mild such as fever, urethritis, and cystitis, to severe, such as calculus formation, acute pyelonephritis, renal scarring, and bacteremia (Letica-Kriegel et al., 2019). CAUTI can also contribute to urosepsis and death if not well-managed. Furthermore, it is important to monitor CAUTI because it negatively affects patient safety and quality of care and increases healthcare costs. CAUTIs are associated with high economic costs due to prolonged hospital stay that contributes to high healthcare costs (Letica-Kriegel et al., 2019). Complications attributed to CAUTI result in an increased patient stay of 2-4 days, patient discomfort, increased health care costs, and increased mortality. The estimated total U.S. cost annually for CAUTI is $340–450 million.

New nurses need to familiarize themselves with the quality indicator on CAUTI when providing nursing care because the CAUTI rate indicates the quality and safety of care provided in an institution. CAUTIs significantly contribute to high morbidity and mortality rates (Letica-Kriegel et al., 2019). It is increasingly becoming a public health problem due to the rising economic and human impact. Besides, the CAUTI problem is likely to exacerbate due to the increasing number of patients with impaired immunity, increased bed-ridden patients, new disease-causing microorganisms, and the increasing bacterial resistance to antibiotics (Letica-Kriegel et al., 2019). Furthermore, new nurses need to be well-versed with the interventions they should take to lower the incidence of CAUTIs. The interventions can include cleansing and disinfecting the external urethral orifice, Antibiotic prophylaxis, reducing catheter use, Probiotics, and using antiseptic-impregnated catheters.

Collection and Distribution of Quality Indicator Data

I interviewed a professional colleague conversant with quality monitoring and how technology can be used to collect and report quality indicator data. The colleague informed me that our organization obtains data on CAUTI from multiple sources of information. Multiple sources are used because there is no single method that is sensitive enough to assure high-quality data. Our organization has an infection control team comprising trained data extractors who conduct active surveillance. The team collects data on CAUTI from inpatient units’ activity, including records of hospitalized patients on catheterization, data on clinical features consistent with UTI in catheterized patients, diagnostic tests, patients on antimicrobial therapy, and reviews from medical and nursing charts.

The infection control team assesses and documents risk factors for CAUTI in the inpatient units, including: the number of patients on extended periods of catheterization; patients catheterized late in the hospital course; catheterized patients not on antimicrobial therapy; catheterized diabetics; and immunocompromised patients. Besides, the team collects laboratory reports that offer reliable data on patients with urinary tract infections. Data is also obtained using data collection forms that collect information on the incidence of CAUTIs in each inpatient unit. Nurses complete a CAUTI incidence form for every catheterized patient. The form collects patients’ demographic data, CAUTI risk factors, and presence of CAUTI, including onset, isolated microorganisms, and antimicrobial susceptibility.

How the Organization Disseminate Aggregate Data?

The infection control team is responsible for disseminating aggregate data in the organization. Data is disseminated to the hospital’s leadership team, outpatient and inpatient units, and laboratories. The team disseminates the data by organizing meetings with the involved departments and healthcare providers and shares the data on the incidence of CAUTIs in the various hospital units. Besides, the team explores strategies that can be implemented to reduce CAUTI rates in the inpatient units with the healthcare providers. In addition, our organization disseminates data using summaries of CAUTIs and graphic presentations that are supplied to the affected inpatient units.

Role Nurses Play in Supporting Accurate Reporting and High-Quality Results

Nurses play a major role in reporting CAUTIs, and they guarantee high-quality results because they take part in direct patient care. Their role includes reporting patients who develop CAUTI, including accurate demographics and interventions implemented to prevent or manage CAUTI (Donohue-Ryan & Schneider, 2021). In addition, nurses have a role in reporting CAUITs on the hospital’s nosocomial infections reporting system, ensuring that all cases are accounted for. Furthermore, accurate nursing documentation is essential in promoting high-quality results.

Nurses are tasked with documenting signs and symptoms of CAUTI on patients’ electronic medical records, which facilitates monitoring of the disease prognosis (Donohue-Ryan & Schneider, 2021). In addition, nurses play a role in accurately filling the CAUTI data collection forms, which helps the infection control team monitor the number of CAUTI cases in the hospital. Nurses also play a major role in ensuring that patients’ records are appropriately stored, either in electronic records or paper form, to prevent data loss.

Conclusion

Nursing-sensitive indicators are elements of patient care that are directly affected by nursing practice. CAUTI is a nosocomial UTI and the most common hospital-acquired infection. However, they are highly preventable if appropriate interventions are taken to minimize inoculation of bacteria into the bladder by the urinary catheter. CAUTIs cause high morbidity and mortality rates and increased healthcare costs. Consequently, nurses should be well-versed with how they occur to take preventive measures. Data on CAUTIs is obtained from patients’ records, diagnostic results, records of patients on antimicrobial therapy, and medical and nursing charts. It is disseminated by the infection control team to the respective departments and healthcare providers.

References

Donohue-Ryan, M. A., & Schneider, M. A. (2021). The CNO’s Role in Promoting Staff Nurse Engagement in Quality Reporting. Nursing Economics, 39(1), 45-48.

Gomila, A., Carratalà, J., Eliakim-Raz, N., Shaw, E., Tebé, C., Wolkewitz, M., … & Pujol, M. (2019). Clinical outcomes of hospitalized patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: the COMBACTE-MAGNET RESCUING study. Antimicrobial Resistance & Infection Control, 8(1), 1-8. https://doi.org/10.1186/s13756-019-0656-6

Letica-Kriegel, A. S., Salmasian, H., Vawdrey, D. K., Youngerman, B. E., Green, R. A., Furuya, E. Y., Calfee, D. P., & Perotte, R. (2019). Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals. BMJ Open, 9(2), e022137. https://doi.org/10.1136/bmjopen-2018-022137

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing‐sensitive indicators for nursing care: A systematic review (1997–2017). Nursing Open, 8(3), 1005-1022. https://doi.org/10.1002/nop2.654

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

NURS-FPX4040 Assessment 4: Informatics and 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.
• 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 [email protected] 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.

Informatics and Nursing-Sensitive Quality Indicators Scoring Guide

Criteria	Non-performance	Basic	Proficient	Distinguished
Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.	Does not describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.	Begins to identify but does not describe the interdisciplinary team’s role in collecting and reporting quality indicator data.	Describes the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.	Describes in a professional manner the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports. Offers valuable insight into the impact of the interdisciplinary team on data collecti Similar Posts health and medical Case 7- The Case Of Physician Do Not Heal Thyself Case 7- The Case Of Physician Do Not Heal Thyself Case 7- The Case Of Physician Do Not Heal Thyself Case… health and medical PSY 202 Week 5 DQ 2 PSY 202 Week 5 DQ 2 PSY 202 Week 5 DQ 2 Understanding that we are not defined by our job… health and medical Assessment 2: Community Resources Assessment 2: Community Resources Community Resources             The WHO is an autonomous body of the United Nations with the mandate to oversee… health and medical An Analysis of Underground Forums Article Discussion An Analysis of Underground Forums Article Discussion An Analysis of Underground Forums Article Discussion An Analysis of Underground Forums Article Discussion… health and medical Case-Study Assignment: Nursing Project Case-Study Assignment: Nursing Project Case-Study Assignment: Nursing Project Case-Study Assignment: Nursing Project Case-Study Assignment: Nursing Project ORDER NOW FOR AN ORIGINAL… health and medical NR 512 Fundamentals of Nursing Informatics Week 2 Quiz NR 512 Week 2 Informatics Key Terms Quiz  NR 512 Week 2 Informatics Key Terms Quiz -2020 | Fundamentals of Nursing…