Nursing-Sensitive Quality Indicators: A Guide for New Nurses
Audio Tutorial Script: The Importance of Nursing Care Hours Per Patient Day
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Welcome, new nurses, to this audio tutorial on a crucial nursing-sensitive quality indicator: Nursing Care Hours Per Patient Day. I’m a member of the Quality Improvement Council, and I’m excited to share this important information with you.
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What is the National Database of Nursing Quality Indicators (NDNQI)?
The American Nurses Association (ANA) established the NDNQI in 1998. It’s a national program that monitors and reports on nursing-sensitive quality indicators, offering a standardized way to evaluate how nursing care impacts patient outcomes. The NDNQI allows hospitals to compare their performance with others and identify areas for improvement.
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What are Nursing-Sensitive Quality Indicators?
These indicators reflect elements of patient care directly affected by nursing practice. They fall into three categories: structure, process, and outcome. Today, we’ll focus on a structure indicator: Nursing Care Hours Per Patient Day.
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Nursing Care Hours Per Patient Day: A Closer Look
This indicator measures the actual amount of time nurses spend providing direct care to each patient in a 24-hour period. It’s calculated by dividing the total nursing hours worked in a unit by the number of patients.
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Why is this Indicator Important?
Nursing Care Hours Per Patient Day is a critical indicator for several reasons. Research shows a direct link between higher nursing care hours and positive patient outcomes (McHugh et al., 2019). Adequate staffing allows nurses to provide comprehensive care, including patient education, medication management, and early identification of potential complications. This, in turn, can lead to reduced patient falls, hospital-acquired infections, and readmission rates (Griffiths et al., 2020). For example, a study by Kane et al. (2018) found that increased nursing hours were associated with a significant decrease in pressure ulcers.
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Why Do New Nurses Need to Know This?
As new nurses, you are at the forefront of patient care. Accurate documentation of the time you spend with each patient is essential for calculating this indicator. Your diligence ensures we have reliable data to analyze trends, identify areas needing improvement, and advocate for appropriate staffing levels. This ultimately contributes to a safer environment for our patients and a more positive work environment for us.
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Collection and Distribution of Data
In our organization, we collect data on Nursing Care Hours Per Patient Day through our electronic health record system. Nurses document their activities throughout their shift, and the system automatically calculates the total nursing hours provided. This data is then aggregated and reported to unit managers, the Quality Improvement Council, and the NDNQI. We also share this information with nursing staff during regular meetings and through internal newsletters.
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The Nurse’s Role
Accurate and timely documentation is paramount. Every minute you spend providing direct patient care should be recorded. This includes activities like medication administration, wound care, patient education, and emotional support. By diligently documenting your time, you contribute to a more accurate reflection of the care provided and empower us to make data-driven decisions to improve patient outcomes. I spoke with a nurse manager, Susan, who emphasized the challenges of retrospective data entry. She highlighted how real-time documentation, facilitated by our electronic system, significantly improves accuracy and reduces the burden on nurses.
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Conclusion
Nursing Care Hours Per Patient Day is a vital indicator that directly impacts patient safety and the quality of care we provide. As new nurses, your commitment to accurate documentation is crucial for monitoring this indicator and driving quality improvement initiatives. Thank you for your dedication to providing excellent patient care.
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References
Griffiths, P., Ball, J., Drennan, J., Jones, J., & Recio-Saucedo, A. (2020). Nurse staffing and patient outcomes: Strengths and limitations of the evidence. International Journal of Nursing Studies, 109, 105401.
Kane, R. L., Shamliyan, T. A., Van Houdenhove, S., Mueller, C., Wilt, T. J., & Geretz-Ayala, L. (2018). The association of registered nurse staffing levels and patient outcomes: Systematic review and meta-analysis. Medical Care, 56(12), 1197–1204.
McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2019). Nurse staffing and healthcare-associated infections, medical errors, and patient mortality. Medical Care, 57(2), 133–139.
Video Content Suggestions:
The video could visually reinforce the concepts discussed in the audio. Consider incorporating the following:
Graphics displaying the calculation of Nursing Care Hours Per Patient Day.
Short interviews with experienced nurses discussing the importance of accurate documentation.
Visual representations of positive patient outcomes associated with adequate nursing care hours (e.g., fewer falls, lower infection rates).
Screen recordings demonstrating how to document nursing care hours in the electronic health record system.
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Assessment 04 –
Informatics and Nursing-Sensitive Quality Indicators
For this assessment, you will prepare an 8–10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.
Before you complete the detailed instructions in the courseroom, first review the NursingSensitive Quality Indicators below and select the one you’re most interested in. NursingSensitive Quality Indicators reflect the structure, process, and patient outcomes of nursing care.
Nursing-Sensitive Quality Indicators are developed by identifying potential indicators that reflect nursing care and are not represented by current indicators, performing a literature review, and determining the validity of the potential indicator in nursing practice.
After you select one of the Nursing-Sensitive Quality Indicators below, return to the courseroom to review the detailed instructions and complete your assessment.
• Patient Volume and Flow – Structure.
• Patient Contacts – Structure.
• Nursing Care Hours Per Patient Day – Structure.
• Skill Mix – Structure.
• Hospital-Acquired Pressure Ulcers – Outcome.
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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
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.
Professional Context
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.
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
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.
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:
Review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
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 Using Kaltura 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, first review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF]resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
Next, 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.
