NURS FPX 4040 Assessment 4 Informatics and Nursing-Sensitive Quality Indicators
The delivery of quality healthcare is the main aim of any healthcare organizations. Quality care contributes to the realization of outcomes of care that include patient satisfaction, empowerment, adherence to treatment, and reduction of healthcare costs. The ability of nurses and healthcare organizations to deliver quality care depends largely on their focus on quality indicators. Quality indicators reflect a number of aspects in nursing that include process, outcome and structural indicators. The realization of the developed sensitive or quality indicators in an organization implies that the outcome, process and structural processes are effective in the organization. Therefore, this presentation examines a selected nursing-sensitive quality indicator and its related aspects that include NDNQI, nursing sensitive quality indicators, importance of the selected indicator and collection of data related to it.
NDNQI and Nursing Sensitive Quality Indicators
The NDQI is a national database that was established for the collection of nursing quality indicators. The nursing quality indicators provide insights into the quality of nursing care given in different health organizations in the state. The American Nurses Association developed NDNQI in 1998 with the aim of developing knowledge in nursing about the factors that are critical in influencing the quality of nursing care to the patients. One of the goals of NDNQI is to develop national data that can be used to measure the relationship between patient outcomes and nurse staffing (Arnold-Long et al., 2018). The other goal of the NDQI is to provide the participant hospitals with the national comparative data of the nursing sensitive indicators for quality improvement initiatives.
As noted above, nursing sensitive quality indicators are sources of data that provide information about the structure, patient and process outcomes of nursing care. The structure outcomes in nursing include aspects such as knowledge and skills of the staffs, education and professional development of the staffs and supply of the nursing staff. Process outcomes focus on the interventions that are used to achieve the desired outcomes of care, job satisfaction level of the staffs and the effectiveness of the organizational processes utilized in the delivery of care. Outcomes focus on aspects such as the realization of the objectives of patient care. An improvement or realization of outcomes of care provides insights into the effectiveness of the adopted process interventions. The nursing sensitive quality indicators that are monitored in the NDQI are varied. They include nursing hours in a patient day, nursing turnover rate, nosocomial infections, patient falls, patient falls with injuries, pressure ulcer rate, pediatric pain assessment, pediatric peripheral intravenous infiltration, registered nurses survey, registered nurses’ education, restraints, and staff matrix (Ju et al., 2018; Koch et al., 2020). Hospitals that are members of the NDQI are expected to voluntary provide data on these sensitive data to guide the implementation of quality improvement initiatives and evidence-based practice initiatives in nursing.
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NURS FPX 4040 Assessment 4 Data Review Project Report and Presentation
Selected Quality Indicator
The selected quality indicator for focus in the presentation is urinary catheter associated urinary tract infections (UTIs). According to evidence, catheter-associated urinary tract infections are among the most common hospital acquired infections in America. The evidence provided by Podkovik et al., (2019), the estimated number of cases of catheter-associated urinary tract infections in the US hospitals in 2011 was two cases in every 1000 hospital indwelling catheter days. Patients who develop catheter-associated urinary tract infections present with symptoms that include fever, costovertebral angle tenderness, suprapubic tenderness, dysuria, urinary frequency, and presence of bacteria or white blood cells on urine culture (Kuy et al., 2020). Patients with indwelling urinary catheter are highly predisposed to urinary tract infections due to a number of factors. One of the factors is the prolonged use of indwelling urinary catheter that predisposes the urinary tract to colonization by bacteria. Improper use of aseptic techniques or preparation for insertion also increases the risk for the development of catheter-associated urinary tract infections (Letica-Kriegel et al., 2019; Omer et al., 2020). The additional risk factors for catheter-associated urinary tract infections include female gender, poor nutrition, severe illness, fecal incontinence, and immunosuppression (Anggi et al., 2019).
Cather-associated urinary tract infections are included in the nursing sensitive quality indicators because they are preventable. Accordingly, appropriate interventions can be adopted in health institutions to prevent them. Examples of interventions that can be embraced in nursing to reduce the infections include appropriate insertion of the urinary catheter, reducing the colonization of bacteria around the urethral area of meatus using antiseptic cleaning solutions, and instituting institutional guidelines and policies that relate to insertion of urinary catheter (Mitchell et al., 2017). Consequently, it is important that new nursing staffs be educated on the factors that contribute to catheter-associated urinary tract infections and ways of minimizing them in practice.
Importance of Monitoring the Indicator
Monitoring catheter-associated urinary tract infections in nursing is important because of a number of reasons. Firstly, the rates of catheter-associated urinary tract infection in an organization indicate the quality and safety of care given to the patients. A high rate of catheter-associated urinary tract infections in an institution implies that the nurses do not possess knowledge and skills that are needed to promote safety in patient care. Catheter-associated urinary tract infections are also monitored due to the adverse health effects that they have. According to evidence, catheter-associated urinary tract infections cause complications that include endocarditis and sepsis. This type of infection is also reported to contribute to more than 13000 deaths every year across the world (Podkovik et al., 2019). Patients affected with catheter-associated urinary tract infections also stay in hospital longer than those who do not develop the infection. The extended hospital stay is attributed to the additional treatment that patients should receive to prevent complications. Extended hospital stay implies that the cost that the patients incur due to catheter-associated urinary tract infections is high (Kuy et al., 2020).
According to the study by Hollenbeak and Schilling (2018), catheter-associated urinary tract infection costs patients and health organizations $876 for additional medications and diagnostic tests. The authors also show that Medicare cost for inpatient costs for non-intensive care unit is $1764 and $8398 inpatient cost for pediatric patients and $10197 for ICU patients (Hollenbeak & Schilling, 2018). According to Mitchell et al., (2017), 380000 bed days are lost on an annual basis in Australia due to catheter-associated urinary tract infections and extended hospital stay. Therefore, considering the above impacts, nurses should be educated on the best practices that are effective in preventing and reducing the rates of catheter-associated urinary tract infections.
