Description
Prepare an 8-10 minute audio training tutorial (video is optional) for new nurses on the importance of nursingsensitive quality indicators.
As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment
Framework activity. Quality healthcare 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.
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Assessment 4 Instructions: Informatics and Nursing Sensitive
Quality Indicators
Prepare an 8-10 minute audio training tutorial (video is optional) for new nurses on the importance of nursingsensitive quality indicators.
As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment
Framework activity. Quality healthcare 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.
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, Gray, Jay, Jay, & Burns, 2015).
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.
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 nursingsensitive 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.
Reference
Grove, S. K., Gray, J. R., Jay, G.W., Jay, H. M., & Burns, N. (2015). Understanding nursing research: Building an
evidence-based practice (6th ed.). St. Louis, MO: Elsevier.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies
through the following assessment 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 and 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.
Preparation
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:
Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care
system.
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 Examplar.
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 the 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, 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 NDNQI®?
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 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 notes MUST be provided.
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.
Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final
Capstone course.
SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.
VIEW SCORING GUIDE
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Hello and welcome to the University Hospital Health Care System. My name is Diane
Tate. We are so excited to have you on our nursing team. I am here today to help you
better understand how our healthcare system uses Nursing Sensitive Quality Indicators
– also known as the NDNQI – to enhance quality care outcomes, improve training
procedures, establish best practices, and improve patient satisfaction. These indicators
also help in workflow and the recruitment and retention of quality staff. You play an
important part of this. You are our eyes and ears when it comes to safe evidence-based
practice and reporting data to help evaluate our Nursing Sensitive Quality Indicators.
We are very fortunate to be one of the 1100 facilities in the United States providing the
data to NDNQI to fulfill nursing’s commitment to advancing our knowledge base to
evaluate and improve patient care. The NDNQI is a national nursing database
evaluating nursing care that provides annual and quarterly reporting of three major
indicators which evaluate nursing care. In 2018, the authors Griggs, Wiechula & Cusack
described those indicators as structure (staff/skill competency), process (patient
assessment, nursing intervention, and job satisfaction) and outcome of patient care
related to the quantity or quality nursing care. NDNQI is managed by a company named
Press Ganey. Press Ganey sends us surveys for the data needed and then provides
participating facility research driven reports with statistics and data themes. Multiple
authors including Smith (writing in 2018) and Griggs, Wiechula & Cusack point out that
this data allows us to understand what we are doing well in our facility and what we
need to improve on, in comparison to national data, to enhance patient safety, patient
care outcomes, and organizational performance reports.
Now I’d like to share an example, Our Chief Nursing Officer used the NDNQI ratios and
acuity data on staffing to validate the need various levels of nurse staffing. Authors
Mangold and Pearson, writing 2017, identify how this type of data can contribute to
significant changes to our staffing matrix and ratios because of the data produced by
nurses like you. Our nurses are better able to provide quality care as a result of this
information and our patient satisfaction scores have almost doubled over that past 6
months.
Imagine a small snowball made of 5 pieces of snow, then imagine one made of 100
pieces of snow, and one made of 1100 pieces of snow…the greater the number the
bigger the impact. If you were in the snowball fight, do you want the snowball made with
five snowflakes or the one made with 1100 snowflakes? The same is true of the data in
the NDNQI, when one facility implements a change the data from the change is shared
with everyone through NDNQI so the dissemination of information is relatively quick and
provides real time evaluation data.
For another example, over the past few months, we have experienced a dramatic rise in
catheter-acquired urinary tract infections also known as CAUTIs and Hospital Acquired
Conditions throughout the facility. This has dramatically affected the quality of patient
care and ultimately our Press Ganey patient satisfaction surveys. Our rate of CAUTIs
and Hospital Acquired Conditions have also impacted our rate of Medicare
reimbursement. We have experienced a 1 percent reduction in reimbursement related
to this CAUTI and associated HAC increase. Porter (2018) estimates CAUTI costs to be
over $10,000. To give this number a little more impact, the Robert Wood Johnson
Foundation Interdisciplinary Nursing Quality Research Initiative reported in 2015 that
there was a total of $330 million dollars lost in Hospital Acquired Conditions penalties
across 721 facilities.
Our nurses have identified CAUTI in their patients with indwelling catheters as a
concern as well as other Hospital Acquired Conditions. Recognizing that they are the
first line of defense for patient safety, our nurses are participating in a hospital wide
Acquired Condition Reduction Program modeled after the Centers for Medicare and
Medicaid services (n.d). Our initiative looks at all infections acquired during treatment in
this facility. I encourage you to look at this website. As a nurse you are the leader of
healthcare quality, we depend upon you as the expert in patient care. YOU are
extremely powerful in contributing to patient care in not only preventing CAUTIs but in
providing a timely reporting of needed data in the Press Ganey surveys so that our data
is contributed to NDNQI.
You May Ask… How Can I Help?
Nurses have an essential role within the interdisciplinary healthcare team. They are
responsible for collecting and reporting data for the NDNQI. The data collected will
contribute to improved outcomes, improved patient safety, and an overall improved
patient experience. In our facility we provide the data using online surveys received
from Press Ganey, all members of the interdisciplinary healthcare team receive the
surveys. In a personal communication, our Chief Nursing Officer, Dr. Smith,
underscored that the current facility best practice is to check your hospital email every
day you work and complete any surveys sent to you. The data is very easy to enter into
the survey. Dr. Smith stated that in the beginning there was a lot of lag time between
data entry by the interdisciplinary team and the time the survey was sent out but that
has improved. We have a quality team at the hospital responsible for supplying the
general data related to CAUTIs. Other data provided to Press Ganey includes incident
reports, patient admission dates, length or stay, readmission data, number of patients
with catheters vs patients with CAUTIs diagnosed in facility vs after discharge. To learn
more about Press Ganey please go to their website.
Your job as a nurse is to provide care according to the current practice policies,
complete all required documentation which includes all popups on CAUTIs and then to
enter data when emailed a survey from Press Ganey. Your role is incredibly powerful in
this initiative because as you know we have a huge amount of responsibility in placing,
caring for and assessing indwelling catheters and straight caths. Imagine if your work in
completing all required documentation and some quick online surveys prevents future
CAUTIs, the impact would be huge!
I would now like to discuss what we do WITH THE DATA
The data you provide, and which is found in the patient records provides insights into
how the nursing care and interventions we provide influence patient outcomes. The data
found within the NDNQI gives healthcare leaders an understand of what actions
influence quality and patient safety. Within the NDNQI the data is trended and the
themes and or statistical information is pulled out to help guide safety and quality
initiatives.
Within this organization we have quality improvement teams on each unit where data
from NDNQI and plans for improving quality are shared. We use the data for guiding us
in creating quality improvement plans and ensuring patient safety. Quality improvement
teams on your unit will share updates with the NDNQI data and how we plan to use the
data.
As we wrap up I’d like to share some ideas about how your actions IMPACT HEALTH
CARE IN GENERAL
Your involvement in accurate charting and completing surveys provides data used for
the greater science of nursing. This information helps the nursing profession to identify
nurse-sensitive indicators of quality to use for improvement in our patient care. Our
nursing leaders use the NDNQI data to determine the best practices for their unit and
facility to improve both quality care outcomes and workplace safety, including nurse
patient staffing ratios.
Our facility models itself after the 2015 Robert Wood Johnson Foundation
Interdisciplinary Nursing Quality Research Initiative Policy Brief for not only quality and
safety improvement, but to achieve higher outcome-based hospital payments. Our
Value Based Purchasing program provides acute care facilities incentive money when
the facility has good performance on quality measurements and makes improvements in
the facilities quality and safety of care. There is also an overlap of the Value Based
Purchasing program and the Medicare reimbursement program so facilities are able to
potentially have double the financial benefit because the nurse sensitive outcomes
influence the requirements for full reimbursement from Medicare. John Hopkin’s hospital
has been a leader in using the NDNQI data to make improvements in safety and quality
with a 41% reduction in CAUTIs with the use of national data on nursing interventions
from NDNQI. Nursing leaders need to work to ensure they use the data from the nursing
sensitive outcomes to make improvements in care within individual facilities and units.
In CONCLUSION
Our involvement in NDNQI is a wonderful and positive influence on the profession of
nursing and patient care. Your responsibility is to ensure you have accurate and
complete documentation and to complete any Press Ganey surveys you receive. Our
role as a facility is to provide all additional data to NDNQI and to support you in your
work while focusing on quality improvement and sharing data with you from NDNQI and
our quality improvement work. The success of NDNQI is relying on our commitment to
provide data in a timely manner and then to use the national data to make
improvements at the facility. Nurses are at the front line of quality improvement and
evidence-based practice. We can all make a huge improvement in patient care. You are
a valuable asset to our team!
Thank you!
Resources:
•
AHRQ(2019). High reliability. Retrieved fromhttps://psnet.ahrq.gov/primers/primer/31.
•
CFAR, Inc., Tomasik, J., Fleming, C. (2015). Promising interprofessional
collaboration. Retrieved fromhttps://www.rwjf.org/en/library/research/2015/03/lessons-fromthe-field.html
•
•
•
•
Clarke, J.R.(2013)The use of collaboration to implement evidence-based safe
practices Journal of Public Health Research:2:(e26)
Deloitte(2017). Transforming into a high reliability organization in health care.
Retrieved fromhttps://edit.modernhealthcare.com/assets/pdf/CH111283727.PDF
Donnelly, P., & Kirk, P. (2015). Using the PDSA model for effective change
management. Education for Primary Care, 26(4), 279–281.
Institute for Healthcare Improvement. (2018). Plan-do-study-act (PDSA)
worksheet. Retrieved
fromhttp://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx
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