NURS-FPX-4040 | Informatics and Nursing Sensitive Quality Indicators

Informatics and Nursing Sensitive Quality Indicators

Hello everybody, and welcome to our tutorial on Nursing Informatics and Nursing Sensitive Quality Indicators. My name is ____________ __________ and I will be taking you through this course. This tutorial will help you to understand what nursing-sensitive quality indicators are and how you can apply these indicators in your quality improvement efforts in your area of practice. We all have an obligation of ensuring that patients in our institutions are safe and are receiving quality healthcare services. Nursing sensitive quality indicators can help us to establish and monitor quality standards in our organizations. During this tutorial, you will learn the importance and application of quality indicators in nursing practice and how these indicators can be integrated with the health information system utilized in your organization.

The quality of healthcare services provided in healthcare settings directly influences organizational and patient outcomes, and Stalpers, Kieft, van der Linden, Kaljouw, and Schuurmans (2016) link it to positive patient outcomes, e.g., safety and high satisfaction levels. Quality indicators are commonly used to measure organizational performance in regards to the quality of health services provided by the organization. The American Nursing Association (ANA) defined Nursing-Sensitive Indicators (NSIs) as measures or indicators that inform on the quality of organizational structures, processes, and outcomes in nursing care. Nurses can utilize these NSIs in quality improvement initiatives. Each of the nursing care elements has its quality measures. For example, nursing hours per patient days (HPPD), skill mix, and the level of education of registered nurses in the organization are commonly used as quality measures for organizational structure. Patient falls may be used as quality measures for both the nursing process and patient outcomes. Nursing interventions, on the other hand, can be used as quality indicators for nursing processes. Furthermore, quality indicators for patient outcomes include readmission rates, hospital-acquired infections, or the Pediatric Peripheral Intravenous Infiltration Rate. The American Nurses Association (ANA) developed NSIs in acute care settings in 1999 (Stalpers et al., 2016). However, over the years, ANA has expanded and developed new NSIs for each nursing care element, including those for non-acute care settings and community-based health settings. Quality indicators establish methods through which quality of health services, process efficiency, and the effectiveness of nursing practices can be achieved.

According to the American Nursing Association, patient falls, or fall-related injuries can be used as quality indicators for process and outcome measures (AHRQ, 2013). Patient falls are one of the most common patient safety issues experienced in hospitals (Dellinger, 2017). They were the second most reported incident, according to a report by the National Joint Commission in 2017 (Agency for Healthcare Research and Quality, 2019). The rates of patient falls, or fall-related injuries can be used to measure the quality of patient safety in an organization. How do these measures indicate the quality of healthcare provided by an organization? High rates of patient falls mean that the nursing practices at the organization require change or improvement. The report by ANA on nurse-sensitive indicators demonstrates that nurses have a professional and ethical obligation of creating environments that are safe for patients (AHRQ, 2013). Falls can cause patients to sustain physical injuries, have extended hospitalization periods, or/and death, depending on the severity of the patient’s conditions.  Death rates resulting from patient falls have doubled since 2000 (Dellinger, 2017). One out of every four adults sustains a fall every year. Over 27000 older adults die every year due to patient falls. The annual Medicare spending on fall-related injuries is $31 billion. The total recorded cases recorded at the national level are 29 million cases—seven million people out of the 29 million sustained injuries. The average cost of treating an injury resulting from a fall is US$10,000. A survey conducted by the Center for Disease Control in 2014 reported that patient falls accounted for 2.8 million emergency visits and 800,000 of the country’s total hospitalization (Dellinger, 2017). Preventing patient falls at the unit level will create safe environments for patients.

Monitoring patient falls is essential in creating an organizational culture of patient safety. Through monitoring, health professionals can track performance and employ strategies to improve patient practices within their settings. The core principle behind measuring a patient's falls is the ability to improve safety based on the outcomes of the quali