Capella 4040 Assessment 4 : Informatics and Nursing-Sensitive Quality Indicators

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Capella University

Capella 4040 Assessment 4

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Introduction

Hello, my name is _____, today I welcome you all to my presentation about nursing-sensitive quality indicators and how technology can help us collect data and report. The session is organized based on an interview with the director of the quality control department. The topic of the conversation was the prevalence of pressure ulcers and the collection and reporting of data. This presentation is based on the same topic. Before I discuss pressure ulcers and how their prevalence is a quality indicator for nursing practice, I would like you to understand the purpose of establishing quality indicators and their importance. 

Nursing-Sensitive Quality Indicators

The American Nursing Association developed the National Database of Nursing Quality Indicators (NDNQI) in 1998, to collect data on specific quality indicators to evaluate and monitor nursing care. These indicators are subdivided into three categories, a) structural indicators, b) process indicators and c) outcomes indicators. This database provides quarterly and yearly reports on various indicators which are helpful for healthcare organizations to improve their nursing practices and care (Barchielli et al., 2022). The goal of NDNQI is to bring together interprofessional teams to work to achieve positive outcomes for patients by improving the quality of care. These measures also indicate the importance of nurses and nursing practices for patients’ well-being and positive healthcare results. Thus, they are highly important for you people as new nurses to understand your role in patients’ lives and this will help you improve your practices in clinical settings. 

Quality Indicator – Prevalence of Pressure Ulcers in Adult Patients

As mentioned earlier, out of several quality indicators, today’s discussion is about pressure ulcers and how incidences of pressure ulcers are related to poor nursing care. Furthermore, we will discuss the importance of improving nursing care for the prevention of these ulcers. Pressure ulcers are confined skin and tissue injuries that are usually caused by friction or pressure that occurs between an object and the surface of the skin. Globally, the progression and deaths related to pressure ulcers have increased by 60% in elderly patients. A report developed in an ulcer summit revealed that around 60,000 people die due to complicated pressure ulcers. Moreover, approximately 700,000 patients develop pressure ulcers and most of them occur due to inadequate care (Tesfa Mengist et al., 2022).

Some of the causative factors for pressure injuries are older age, bladder incontinence, a bedridden state, lack of proper nutrition and water intake, neurological deficiency, pressure on the skin due to medical devices, and multiple secondary diagnoses. As frontline care staff, nurses are primarily responsible healthcare providers with the major responsibility to prevent pressure ulcers by enhancing their knowledge and practices. Caring for patients’ pressure areas is an imperative element of nursing practices. The nurses must maintain patients’ skin integrity and prevent complications. This is done by early recognition of high-risk patients and providing special attention to them for which nurses must be knowledgeable and have an insight into their poor practices (Ebi et al., 2019). These positive outcomes are better achieved when multidisciplinary teams work together. 

Interdisciplinary Teams’ Role in Collecting and Reporting Data 

Healthcare facilities function with the help of interdisciplinary teams; thus, data collection and establishing an organizational report on quality indicators also require a team of individuals from various professions. Nurses play an important role in this regard. The process of data collection for pressure ulcers (PU) and the knowledge of nurses related to PU include nurses, nurse instructors, the quality control department, the IT department, and administrators if the incidences are high and require hospital management to be involved. To collect effective data two things are required; a) a pressure ulcer reporting system and b) a questionnaire for nurses.

Some of the hospitals in the US have this in-built software called Medicare Patient Safety Monitoring System (MPSMS), which is developed for various patient safety indicators (Smith et al., 2018). The purpose of this software is to report every new hospital-acquired incidence of PU or any old pressure ulcers which get complicated during the hospital stay. This reporting system is then audited by the quality control department to identify the high-risk units in the hospital. Then, data is disseminated among the stakeholders of each patient unit to identify the risk factors in nursing care. 

Capella 4040 Assessment 4

Another approach to data collection and reporting is by analyzing nurses’ knowledge related to PU. For this purpose, nurses are given a survey questionnaire which is then submitted to the nurse instructors. The data collected from surveys is then transmitted in the statistical software on the computers. The data is then compiled in mean and percentages which help to identify the average of nurses who lack knowledge about pressure ulcers and give an idea to instructors for conducting educational training (Ebi et al., 2019). 

The data collected helps in improving patients’ safety through various unit-level and organizational-level interventions thus improving the quality indicators of the organization. Interprofessional team members when working together in their areas of expertise will be able to collect the data effectively, analyze it using various technologies, prepare organizational reports, and bring successful reforms in the organization to improve patients’ safety. 

Nursing-Sensitive Quality Indicators for Healthcare Organizations

So as we discussed earlier, nursing-sensitive quality indicators are essential to improve the results of the data collected, eventually enhancing quality care. Healthcare organizations use these indicators for three purposes, 1) improving patients’ safety, 2) enhancing patient care outcomes, and 3) improving organizational performance reports. 

Like other hospitals, our organization is also interested in providing quality care to the patients, especially in terms of decreasing the incidences of  pressure ulcers. Nurses being the frontline care providers have this responsibility to ensure care quality and patients’ safety (Vaismoradi et al., 2020). The data received from NDNQI about the prevalence of pressure ulcers helps nurses and nurse leaders to examine and evaluate current hygiene care practices and the positioning of high-risk patients. Then this information can be used by the nurses to improve their nursing care which eventually impacts positive patient outcomes. Moreover, hospitals use this data to launch organizational goals for improvements at the unit and hospital level, which improves the overall performance of an organization to reduce hospital-acquired pressure injuries. Nurse leaders can use it to educate nurses about patient-centered, safe, and beneficial care to improve patient outcomes, decrease pressure ulcer complications, and increase patient safety and satisfaction levels ultimately decreasing accountability issues (Sevy Majers & Warshawsky, 2020). 

Evidence-Based Practices (EBP) Guidelines for Nurses 

Technological advancements for evidence-based practices in nursing have been beneficial in terms of improving patient outcomes if used effectively. Nursing-sensitive quality indicators help in developing evidence-based guidelines for using patient care technologies. In a study, participants mentioned that quality indicators are assessment tools for their practices. They help nurses to know their care levels and make a decision related to evidence-based health practices (Báo et al., 2019). These quality indicators act as guiding principles for nurses to improve their knowledge about current and new technologies in their hospitals so that they are used effectively for patients’ safety.

For example, the Pressure Ulcer Monitoring Platform (PUMP) is a non-contact device that records the repositioning of patients. It was developed after finding high incidences of pressure ulcers in NDNQI. These quality indicators helped nurses and nurse leaders to identify patients with higher risks and ensure they are timely repositioned (Minteer et al., 2020). Thus these technologies when used by following guidelines can improve patients’ safety, and outcomes and eventually improve quality care. 

Conclusion

In conclusion, nursing quality indicators are helpful for hospitals to develop evidence-based practices, improve patient outcomes, enhance patients’ safety, and improve the organization’s healthcare quality. I hope today’s session was insightful for you all as newly trained nurses and you would have learned about nursing quality indicators and their importance. I hope you will incorporate these learnings in your clinical practice to ensure patients are in safe hands. 

References

Báo, A. C., Amestoy, S. C., Moura, G. M., & Trindade, L. de. (2019). Quality indicators: Tools for the management of best practices in health. Revista Brasileira De Enfermagem, 72(2), 360–366. https://doi.org/10.1590/0034-7167-2018-0479 

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), 1373. 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 

Minteer, D. M., Simon, P., Taylor, D. P., Jia, W., Li, Y., Sun, M., & Rubin, J. P. (2020). Pressure ulcer monitoring platform—a prospective, human subject clinical study to validate patient repositioning monitoring device to prevent pressure ulcers. Advances in Wound Care, 9(1), 28–33. https://doi.org/10.1089/wound.2018.0934  

Sevy Majers, J., & Warshawsky, N. (2020). Evidence-based decision-making for nurse leaders. Nurse Leader, 18(5), 471–475. https://doi.org/10.1016/j.mnl.2020.06.006 

Smith, S., Snyder, A., McMahon, L. F., Petersen, L., & Meddings, J. (2018). Success in hospital-acquired pressure ulcer prevention: A tale in two data sets. Health Affairs, 37(11), 1787–1796. https://doi.org/10.1377/hlthaff.2018.0712 

Tesfa Mengist, S., Abebe Geletie, H., Zewudie, B. T., Mewahegn, A. A., Terefe, T. F., Tsegaye Amlak, B., Tadesse, B., GebreEyesus, F. A., Tsehay, T., Solomon, M., Chekole Temere, B., Geze Tenaw, S., & Mesfin, Y. (2022). Pressure ulcer prevention knowledge, practices, and their associated factors among nurses in gurage zone hospitals, South Ethiopia, 2021. SAGE Open Medicine, 10, 205031212211055. https://doi.org/10.1177/20503121221105571 

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028 

Capella 4040 Assessment 4