Nurse-Sensitive Indicators of Quality
Montalvo (2007) mentioned a total of fourteen nurse-sensitive quality indicators that focus on process, structure, and outcomes. These indicators were created and validated by the National Database of Nursing Quality Indicators (NDNQI). One of the original indicators is patient falls, which is a measure of both quality and process. It appears that the indicator was influenced by Florence Nightingale’s Environmental Theory. According to the theory, the purpose of nursing is to utilize the environment of the patient to assist him in his recovery (Hegge, 2013). Preventing falls is associated with modifying the environment, such as lowering beds of in-patients, posting fall risk alerts, and using bed alarms (Chu, 2017). Thus, using falls as an indicator seems to demonstrate how well nurses use the environment to assist patients in their recovery. Another indicator is the Pediatric Peripheral Intravenous Infiltration Rate, which was clearly inspired by Deming’s framework of healthcare quality. According to Deming, paying more for bad outcomes is incorrect, which implies that all the costs of adverse outcomes should be shifted to the care provider (Nash et al., 2019). Since the outcome is under the jurisdiction of nurses, it is clear that they should take full responsibility for it.
Articles about Quality Indicators that Impact My Practice
I have significant experience as a dialysis nurse, as I have been working in this position for almost 30 years. One of the quality indicators I found was the percentage of patients on dialysis referred to transplantation evaluation (Plantinga et al., 2017). It is a well-known fact that a kidney transplant is the most effective treatment of kidney failure, as it is associated with positive outcomes. Plantinga et al. (2017) state that healthcare organizations should try and keep this percentage between 22.9% and 28.6%. This encourages nephrologists to refer patients for transplant evaluation actively. Another quality indicator in the dialysis department is the staffing level discussed by Wolfe (2011). This indicator encourages managers to keep the staffing levels adequate to ensure that nurses and doctors can perform their duties adequately, as increased working hours lead to employee fatigue and adverse patient outcomes.
References
Chu, R. Z. (2017). Preventing in-patient falls The nurse’s pivotal role. Nursing2020, 47(3), 24-30.
Hegge, M. (2013). Nightingale’s environmental theory.Nursing Science Quarterly, 26(3), 211-219.
Montalvo, I. (2007). The national database of nursing quality indicators (NDNQI®).OJIN: The Online Journal of Issues in Nursing, 12(3), 112-214.
Nash, D. B., Joshi, M. S., & Ransom, E. R., & Ransom, S. B., (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4 ed.). Health Administration Press.
Plantinga, L. C., Pastan, S. O., Wilk, A. S., Krisher, J., Mulloy, L., Gibney, E. M., & Patzer, R. E. (2017). Referral for kidney transplantation and indicators of quality of dialysis care: A Cross-sectional Study. American Journal of Kidney Diseases, 69(2), 257-265.
Wolfe, W. A. (2011). Adequacy of dialysis clinic staffing and quality of care: a review of evidence and areas of needed research. American Journal of Kidney Diseases, 58(2), 166-176.