Nurses are one of the essential groups when it comes to the provision of quality health care for better patient outcomes. Professionalism in health care has a direct impact on patient outcomes. To improve healthcare quality, nurses have the responsibility to collect data and provide satisfying results to patients. Data is identified as the base through which any quality improvement is gauged. Quality indicators have been identified as critical factors in determining the quality of nursing care by optimizing the patient’s outcome. Quality indicators and performance measurements in nursing care have been identified as areas of comparison against other facilities of similar sizes ( Grove et al ., 2015).
National Database of Nursing Quality Indicator (HDNQI)
In 1998, the American Nurses Association (ANA) formed a team that developed a quality measurement tool known as the National Database of Nursing Quality Indicator (HDNQI). ANA has the sole responsibility of ensuring safety and quality in the country’s healthcare sector; thus, establishing the NDNQI initiative was a great achievement to improve patient care from different facilities through comparison and highlighting areas of attention ( Montalvo, 2007) . The nursing-sensitive indicator has been identified to consider the following major aspects – nursing care, the process, operation structure, and outcomes. The operational index highlights the availability of nursing staff, process indicators consist of guidelines on patient assessment, nursing involvement, and job gratification in the health facilities. The outcome indicator considers the patient determined as nursing-sensitive and entirely depends on available excellence and quality of healthcare.
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American Nurses Association (ANA) recognizes that various indicators should exist in a health-based nursing facility. For this tutorial, catheter-associated urinary tract infection (CAUTIs) has been selected since they are the most reported cases of hospital-acquired infections in an inpatient setting. Deferent researchers have identified over 560,000 patients who develop CAUTIs and continue to develop the disease despite the quality improvement interventions put in place by healthcare facilities ( Buhlman, 2016) . The increase in CAUTIs has been associated with adverse outcomes necessitating an extended stay in the hospital, increased hospital bills, and increased mortality and morbidity in the hospital. Patients’ safety has been put at risk by the increase of CAUTIs. ANA has the crucial responsibility of preventing CAUTIs among inpatients in the healthcare facilities. This is possible by transferring this responsibility to qualified and professional nurses who have the sole responsibility of ensuring inpatient settings are free from CAUTIs infection. The prevention of CAUTIs is directly attached to the quality of nursing care. Therefore, it is essential to engage nurses in preventing its occurrence since it is a preventable disease.
Interview
The Infection Control Nurse at Northern Navajo Medical Center was chosen for this study. It was essential to consider this healthcare facility since it collected CAUTIs data on weekly bases through nursing reports and chart reviews. It was possible to gather information on where the Foley Cath was placed and how long it was inserted through chart reviews. However, according to the Control Nurse, chart reviews could be difficult and time-consuming, especially where the chart is incomplete or inaccurately filled. Therefore, it is difficult to interpret the information when the required CAUTIs data is missing in the table ( Panchisin, 2016) . The floor nurse has the responsibility of collecting accurate data, disseminating the data to the relevant offices either monthly, quarterly, or any other agreed reporting dates as per the health facility.
Data Collection and Reporting
Data collection could be defined as the process of gathering, analyzing, and interpreting information on variables of interest in a systematic way aimed at answering predetermined questions or evaluating outcomes. To make informed decisions, nurses utilize various collected data daily, including vital signs, lab tests, and assessments. The data gathered helps to build a strong foundation for decision-making in healthcare. Both the healthcare staff and systems must guarantee reliability and integrity on the data collection process primarily through its accuracy and completeness. Intensive data collection process, analysis, and evaluation have been attributed to improved patient care outcomes, safety, and quality improvement.
How to Improve Healthcare through Quality Indicators
Different facilities exhibit different levels of quality and safety of nursing care. Nonetheless, it is essential to adopt nursing-sensitive indicators to provide quality healthcare, measure nursing care, and impact patient outcomes. Healthcare facilities have the responsibility to compare the data collected from their nursing-sensitive- signs from other different healthcare organizations of similar size and setting. The comparison provides a benchmark, highlights areas of weakness, and implements quality improvement interventions in healthcare. The use of nursing-sensitive indicators helps the facilities identify areas concern and submit corrective measures to be undertaken before adverse occurrences. The NDNQI has allowed healthcare facilities to compare data from other health care organizations of similar settings ( Killaspy, 2017) . However, the main aim of comparison should be identifying areas of improvement and establishing evidence-based practices. Poor patient outcomes or issues should be corrected promptly and with great concern to ensure effective nursing care in the facility. Some of the evidence-based programs could be seen in different procedures and techniques adopted by the facility, including washing hands and sterilizing surgical tools, among others.
In the current dynamic health systems, technology has dramatically impacted education and nursing work in general. Adopting appropriate information technology and education programs has immensely contributed to quality nursing care in various healthcare facilities. These include healthcare promotion, internet, and network connectivity, and the use of advanced systems. Other benefits of informatics in nursing include ease of data recovery, data transfer, decision support system, patient care, human-computer interaction, imaging informatics, intelligent systems, and electronic patient records, among others ( Martin et al., 2108) . Access to appropriate information technology by nurses ensures improved diagnosis and patient outcomes. Providing nurses with accurate information will guarantee proper medical care. Electronic health records (EHRs) have been identified for disease diagnosis, reduction of medical errors, and improve patient outcomes. EHRs have also been defined to improve the hazardous management and obligatory prevention through the provision of medical alerts and prompt reminders, enhanced communication on information regarding the patient, and therapeutic assessments that support evidence-based action in the healthcare facility.
Interprofessional collaboration has been identified as an essential aspect in the healthcare realms with different individuals or teams collaborating in collecting analyzing and reporting quality indicator data given enhancing patient safety, outcomes, and healthcare performance report. The Health Resource and Service Administration (HRS) advocate for practical inter-professional communication skills and the understanding of specific roles in a team to achieve optimal patient care and to ensure ongoing education in pursuit of team-based competencies ( Mangold & Pearson, 20170) . Multidisciplinary teamwork has the responsibility to empower team members that necessitate continuous success in eliminating any associated infection and ventilator-associated pneumonia, among other conditions. The weak relationship between the nurses and the physical could result in increased mortality, readmission rate, or more extended hospital stay. From different researches, high-function critical care teams have been identified to achieve optimal patient outcomes. Interdisciplinary teams ensure the establishment and sustainable support work environment in the health facilities, realizing improved processes and outcomes.
Patient care technology has received greater acceptance in the field, transforming how nursing care is conducted and delivered. Technology adoption has revolutionized the way nurses contacted patient care, including replacing use sense in treating patients to use of more improved tools such as pulse oxymetry in determining the amount of oxygen in the blood. Despite the very many benefits, technology has been identified with many loopholes in the field of healthcare, proving to range from the complexity of the devices, costs involved, poor interface connectivity, and rapid change of technology rendering some tools outdated ( Heslop et al., 2014) . Patient care technology has grown from relative and straightforward devices such as syringe to sophisticated methods, including electronic health records and barcode medication administration systems, among others. I recommend that nurses should adopt the use of technology in enhancing quality and safety for the patient in the following area; communication among nurses and physicians, reduce prevalent errors, ease access to patients’ health records and increase patient-centered care. Technology has more significant impacts on patient safety and provides easy access to information, especially on the patient and the drug to be administered ( White, 2017) .
In justifying the use of nursing-sensitive quality indicator, it is evident that patient safety is an essential aspect which concerns fiscal pressure and patient expectation on the provision of quality nursing services. All nurse managers have the responsibility to manage nurse-sensitivity indicators and being aware of the factors that can affect or influence the use of indicators various levels. Different strategies have to be implemented in promoting and integrating such indicators as routine nursing care practices.
In conclusion, nursing-sensitive quality indicators are essential in determining the impacts and quality of nursing care. The quality of direct patient care has a more significant impact on patient outcomes since the patients entirely depend on healthcare professionals in getting quality healthcare and improved outcomes. Due to technological advancements in the health sectors, every health facility has to ensure that it is maintained track for the nursing quality care, providing safer and better care for its patients.
References
Buhlman, N. (2016). Nurse staffing and patient experience outcomes: A close connection. American Nurse Today , 11 (1), 49-52. https://www.myamericannurse.com/wp-content/uploads/2016/01/ant1-Focus...Staffing-1217.pdf
Grove, S. K., Gray, J. R., Jay, G.W., Jay, H. M., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th edition). St. Louis, MO: Elsevier.
Heslop, L., Lu, S., & Xu, X. (2014). Nursing-sensitive indicators: A concept analysis. Journal of Advanced Nursing , 70 (11), 2469-2482. https://doi.org/10.1111/jan.12503
Killaspy, H. (2017). Quality indicators for mental health services. In Razzouk D. (Ed.), Mental health economics (pp. 205-213). Springer.
Mangold, K., & Pearson, J. (2017). Making sense of nursing-sensitive quality indicators. Journal for Nurses in Professional Development , 33 (3), 159-160. https://doi.org/10.1097/NND.0000000000000323
Martin, C., Sturmberg, J. P., Stockman, K., Campbell, D., Hederman, L., Vogel, C., & Smith, K. (2018). Supporting complex dynamic health journeys using conversation to avert hospital readmissions from the community: an ecological perspective incorporating interoception. In Sturmberg J. (Ed.), Putting systems and complexity sciences into practice (pp. 51-71). Springer.
Montalvo, I. (2007). The national database of nursing quality indicators (NDNQI). Online Journal of Issues in Nursing, 12 (3), 1-11. https://doi.org/ 10.3912/OJIN.Vol12No03Man02
Panchisin, T. L. (2016). Improving outcomes with the ANA CAUTI prevention tool. Nursing2020 , 46 (3), 55-59. https://doi.org/10.1097/01.NURSE.0000480603.14769.d6
White, C. (2017). The future awakens: A report on the 2016 Vizient Clinical Connections Summit. American Journal of Medical Quality , 32 (1), 3S-30S. https://doi.org/10.1177/1062860617701070
