Nursing professionals are vital in facilitating healthcare services that meet the required caregiving standards in a care setting. Nursing Sensitive Quality Indicators (NSQI) are recommended healthcare standards used to assess and evaluate nurses’ performance to improve the quality of caregiving and generate desired patient and organizational outcomes. NSQI indicates nursing performance thresholds required to generate satisfactory patient safety and satisfaction (Blume et al., 2021). Obtaining these indicators enables healthcare organizations to implement change management strategies to improve health outcomes. The National Database of Nursing Quality Indicators (NDNQI) is a national database that provides comprehensive reporting on healthcare organization’s performance by evaluating the structures, processes, and outcome indicators to develop and implement changes to deliver the required standards of caregiving (Avsar et al., 2020). NDNQI focuses on building structural and process functions in a health organization, such as nurse staffing levels, adherence to nurses’ ethical principles, and nursing competencies that promote good quality care. The National Database links these factors to patient outcomes and evaluates the findings at the unit level to improve the quality of patient care in a healthcare environment. NDNQI is responsible for measuring and evaluating healthcare processes to improve the practice and promote positive outcomes. Structural indicators in an organization include nurse staffing levels, while process indicators refer to nurses’ skill levels and competencies, such as adherence to the nursing code of ethics (Headlam & Illsley, 2021). Outcome indicators are implications of the organization’s structure and processes that affect the quality of care, such as patient falls and pressure ulcers.
Selected Quality Indicator
The outcome indicator chosen for this analysis is patients’ pressure injuries acquired while undergoing treatment in a care setting. Pressure injuries, also known as pressure ulcers, are injuries to a patient’s skin and underlying body tissues caused by prolonged exposure of the skin to pressure. Pressure ulcers commonly affect regions of the skin that cover bony areas such as ankles, hips, and heels. Medical conditions that lead to prolonged bed rest or limit patients’ mobility levels increase their susceptibility to pressure injuries and associated adverse health effects (Headlam & Illsley, 2020). The most common types of patients affected by pressure injuries are patients in a coma and those on wheelchairs; these patients have limited mobility and thus expose their bodies to prolonged pressure, leading to the gradual development of injuries to their skin and underlying body tissues. Hospital-acquired pressure ulcers can be prevented by implementing effective structural and process indicators in a healthcare organization. Healthcare facilities should improve nurses’ staffing levels to provide comprehensive care for hospitalized patients and minimize the chances of acquiring pressure ulcers while receiving treatment (Griffiths et al., 2020). Nurses should be evaluated for essential competencies, including adherence to ethical principles that enable them to adopt strategies that promote patient safety during caregiving. Measures should be undertaken to facilitate the effective detection of pressure ulcers and provide timely intervention to prevent associated adverse health outcomes.
Importance of Quality Indicators
Quality indicators provide a basis to assess and evaluate nurses’ performances and recommend change management strategies to improve the quality of patient care and drive the achievement of desired health goals and objectives. Structural quality indicators involve organizational features designed to facilitate adequate provision of care and improve the quality of patient care. Structural indicators include financial resources, staffing levels, knowledge and expertise, and access to healthcare technology (Oner et al., 2021). These outcomes influence nurses’ ability to perform when undertaking intervention and treatment for hospitalized patients. Adequate staffing improves organizational workflow by increasing nurse-to-patient ratios to provide comprehensive inpatient care (Blume et al., 2021). Process indicators include measures undertaken by a health organization to provide quality healthcare services, including education and training of health workers, implementation processes, and leadership strategies designed to improve the quality of caregiving in a healthcare environment (Headlam & Illsley, 2020). Process indicators also involve evaluating nurses’ ethical principles that guide patient-centered care. The basis of evaluating nursing competencies is the code of ethics, which guides healthcare workers to embrace the best practices required to achieve desired patient outcomes.
Collection and Distribution of Information
The information evaluation process involves collecting, analyzing, and distributing information related to specific structural and process indicators in a health organization. Random surveys will determine the magnitude of resources and other structural factors affecting the quality of caregiving in the healthcare facility. Health workers will be interviewed to provide opinions and perspectives regarding the frequency and susceptibility to pressure injuries for patients admitted to the hospital (Blume et al., 2020). A comprehensive analysis will be conducted to develop and implement a change management process to reduce the frequency of hospital-acquired pressure ulcers and related adverse health effects. Health workers will analyze previous outcomes to collect sufficient information regarding the prevalence of pressure ulcers and contributing factors. Other measures that will be obtained during the survey include nurses’ levels of job satisfaction, susceptibility to burnout and exhaustion, experience in caring for hospitalized patients, and application of professional ethics in promoting access to quality patient care (Avsar et al., 2020).
Nurses’ staffing levels affect the quality of care provision for hospitalized patients. The hospital management must strive to recruit and train more healthcare professionals to provide comprehensive patient care to prevent and manage pressure ulcers more effectively (Griffiths et al., 2020). Nurses should be trained to undertake the best strategies to ensure that patients are comfortable; their sleeping positions should be changed regularly, and their ankles, elbows, and other bony surfaces should be adequately supported to reduce the risk of developing pressure injuries. Additionally, nurses should be equipped to detect pressure injuries during the early stages and implement intervention strategies to achieve positive patient outcomes (Griffiths et al., 2020). Furthermore, nurses’ adherence to ethical nursing principles enables them to resolve ethical issues and make better decisions to achieve positive patient outcomes when providing inpatient care. There is a need to guide health professionals to collect accurate information and record it on patients’ electronic health records which relevant care specialists can access to provide the required treatment.
The organization’s leader will analyze the collected information and later submitted to the National Database of Nursing Quality Indicators (NDNQI) for evaluation and recommendation. The national database will assess the findings and send a report to the healthcare organization. The report includes the results of the evaluation of quality indicators, subsequent conclusions, and recommendations to improve the quality of care and achieve better health outcomes (Oner et al., 2021). The organization will implement change management strategies according to performance recommendations by the NDNQI to reduce the impact of hospital-acquired pressure injuries.
Conclusion
Nursing-sensitive quality indicators are parameters employed to assess and evaluate organizational performance to improve the quality of care and generate positive patient outcomes. Structural outcomes are quality indicators that include human and financial resources available to improve health outcomes for a specific health issue. Process indicators reveal the means employed to provide healthcare services in a healthcare facility; they include workers’ level of training, leadership qualities, and change implementation strategies to prevent adverse health effects of outcome indicators. Outcome indicators determine the impact of structural and process indicators in promoting quality caregiving in a health organization. The National Database of Nursing Quality Indicators evaluates nursing competencies and performances to recommend change strategies to achieve positive patient outcomes while managing pressure ulcers.
References
Avsar, P., Moore, Z., Patton, D., O’Connor, T., Budri, A. M., & Nugent, L. (2020). Repositioning for preventing pressure ulcers: a systematic review and meta-analysis. Journal of wound care, 29(9), 496-508.
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Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group. (2020). Nursing workload, nurse staffing methodologies, and tools: A systematic scoping review and discussion. International Journal of Nursing Studies, 103, 103487.
Headlam, J., & Illsley, A. (2020). Pressure ulcers: an overview. British Journal of Hospital Medicine, 81(12), 1-9.
Lake, E. T., Riman, K. A., & Sloane, D. M. (2020). Improved work environments and staffing lead to less missed nursing care: A panel study. Journal of Nursing Management, 28(8), 2157-2165.
Oner, B., Zengul, F. D., Oner, N., Ivanova, 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.
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