The term nursing-sensitive indicators refers to any nursing activity that directly contributes to patient outcomes. Nurses interact with patients most, therefore their practice is closely monitored in evidence based practice. Nursing-sensitive indicators were ten when first coined in 1996, but researchers, upon prove that an issues qualifies as a nursing indicator, add new indicators annually (AHRQ, 2020). The indicators are classified as structure, process and outcomes indicators, according to the National Database of Nursing Indicators (2019). Among the first ten was nosocomial infections (NI), a patient outcome, based on a nursing-indicator framework tool developed by Connolly & Wright (2017). The issue has been relevant since 1996 since it is recurrent and occurs in almost all healthcare facilities.
Also known as hospital-acquired infection, nosocomial infections are all infections that occur within 48 hours after the patient is admitted (Ju et al, 2018). Hospital infections have remained a top nursing-indicator since nurses play a significant role in preventing them. All condition, including those that may have pre-incubated before the patient was admitted, are also counted as hospital infections. According to Ju et al (2018), ten patients in every one hundred have NIs, with a higher occurrence in developing countries. The most common is post-surgical infection, which poses a challenge to nurses on handling of patients before, during and after surgery. NIs increase morbidity, mortality, hospital re-admissions, and reduce patient outcomes.
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Nurses need to learn how to provide medication, disinfect, sterilize, dress and change clothing of patients for them to help reduce occurrence of NIs. Nurses are also charged with the responsibility of educating the patient on general hygiene and possible avenues of infection, since the nurses may play their role, but the patient is reckless. Educating the patient’s visitors on the dos and don’ts also prevents a possibility of an NI. Nurses are also in more direct contact with patients, thus also pose a danger of transmitting an infection from one patient to another. It is likely that a nurse will overlook the outlined requirements on hygiene until a patient becomes infected. In the nursing world, getting the patient go home faster is the driving force, so all protocols that are aimed at achieving that must be obeyed. In the event that a patient proves that a medic’s negligence increased their stay in hospital or caused a new condition, legal action is taken against the hospital, and consequences include loss of the individual’s job and withdrawal of practicing license.
NIs are especially a problem at a time that bacteria mutate fast and are antibiotic resistant. Nursing therefore aims at preventing infections more than treating them. The nursing career is a place of continuous learning, so being a newbie should not a reason to be scared of making mistakes. The NIs topic can be demotivating or cause skeptic ism for new nurses since they are blamed for almost all hospital infections. Nevertheless in the event that it occurs, Lavin, Harper, & Barr (2015) provide intervention strategies that will eliminate accompanying complications. For a suspected case of infection, a test to confirm the location and type of pathogen is done, and then an infection control program is developed, depending on the infection rate, location and type of pathogen. While some may be dealt with in a few days, some antibiotic resistant strains such as MRSA may take weeks. The nurse in-charge is tasked with systematic collection, analysis, and interpretation of all data essential for implementation and evaluation of the interventions. During this phase, keeping the physician in-charge updated is essential, as it helps both the nurse and doctor note deterioration or improved, and use the data to recommend alternative interventions (Rahn, 2016). In case the patient takes longer than expected or a hospital infection becomes more complicated than the patient’s initial illness, the nurse must remove optimistic in the eyes of the patient, as they are in constant interaction with patients, thus form perceptions of the whole healthcare facility.
References
Connolly, D., & Wright, F. (2017). The nursing quality indicator framework tool. International Journal of Health Care Quality Assurance, 30(7), 603–616.
Ju, Q. -Y., Huang, L. -H., Zhao, X. -H., Xing, M. -Y., Shao, L. -W., Zhang, M. -Y., & Shao, R. -Y. (2018). Development of evidence ‐ based nursing ‐ sensitive quality indicators for emergency nursing: A Delphi study. Journal of Clinical Nursing, 27(15–16), 3008–3019.
Lavin, M. A., Harper, E, & Barr, N (2015). Health information technology, patient safety, and professional nursing care documentation in acute care settings. Online Journal of Issues in Nursing, 20(2), 6.
National Database on Nursing Quality Indicators. Retrieved from https://nursingandndnqi.weebly.com/ndnqi-indicators.html
Rahn, D. J. (2016). Transformational teamwork: Exploring the impact of nursing teamwork on nurse-sensitive quality indicators. Journal of Nursing Care Quality, 31(3), 262–268.
U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (n.d.). Quality improvement and monitoring at your fingertips. Retrieved from https://www.qualityindicators.ahrq.gov
