Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Hi to everyone! Welcome to my session. My name is_____. Today’s presentation is about Hospital-Acquired Pressure Ulcers (HAPU) as a patient outcome Nursing-Sensitive Quality Indicator (NSQI), to educate and train nurses on the importance of Quality Indicators (QI) in the medical setting. Nurses should assess and enhance this QI to boost the care standard and patient satisfaction in medical settings. The agenda of this presentation is:

• Introduction of National Database of Nursing-Sensitive Quality Indicators (NDNQI) and NSQIs
• The significance of monitoring HAPU as NSQI and its part in nursing practice 
• Collection and distribution of QI data 
• Role of nurses and interprofessional teams in gathering and reporting HAPU-related data
• The significance of NSQIs in creating regulations for nurses to utilize healthcare technologies

Introduction of National Database of Nursing-Sensitive Quality Indicator

The American Nursing Association developed the NDNQI in 1998. It is the national nurse database that offers annual and quarterly data on the framework, procedure, and result variables used to assess nursing services at the facility level. NDNQI strives to increase nursing efficiency and patient safety. It serves as a benchmark for clinical nursing (Alshammari et al., 2023). NDNQI aspires to put together interdisciplinary groups to improve patient outcomes by boosting the standards of care.

Nursing Sensitive Quality Indicators (NSQIs)

NSQIs are measures for change in a patient’s medical conditions, which are directly related to nursing care practices. These indicators act as the framework for observing the standard of nursing practices. NSQIs are credible tools because they include objective evaluation, clinical procedure enhancement, assessment of nursing care efficiency and effectiveness, and the capacity for patients to make educated decisions while selecting a medical facility for treatment (Oner et al., 2021).

For this tutorial presentation, I have chosen HAPU as a critical NSQI. Tracking this indicator is essential to minimizing patient harm and providing efficient care. Monitoring the occurrence and severity of HAPU enables medical staff, particularly nurses, to pinpoint areas for enhancement for efficient patient care. 

Healthcare-Associated Pressure Ulcers

HAPUs represent the most dangerous events in the clinical setting. HAPU, or pressure injuries, are lesions to the skin that involve tissue injury resulting from the intrusion of pressure or stress. HAPUs pose mental, physiological, and social difficulties due to patients’ lower quality of life, rising reliance on others, and susceptibility. HAPUs affect almost 2.5 million patients in America, putting patient safety at risk (VanGilder et al., 2021). It imposes a financial burden on patients and medical systems. It costs between $9.1 and $11.6 billion annually.

Medical care expenses are $20,900 to $151,700 for each HAPU case (Yu et al., 2022). It indicates inadequacies in nursing care practices, like poor skin evaluations, inadequate turning guidelines, and improper pressure displacement measures. Furthermore, monitoring these HAPU cases provides significant information for quality enhancement programs and standard conformity, resulting in improved patient safety and treatment.

New nurses must be proficient and familiar with HAPU data to employ Evidence-Based Practice (EBP) care strategies and enhance nursing care, reducing patient safety issues. This understanding enables nurses to deliver proactive, holistic care, promoting patient safety and recovery (Gedamu et al., 2021). Knowledge of the significance of HAPU avoidance and monitoring allows new nurses to assist in mitigating patient harm and enhancing healthcare quality.

Collection and Distribution of Quality Indicator Data

For collecting the QI data related to HAPU, my organization uses two digital systems. These include Electronic Health Records (EHR) and the Medicare Patient Safety Monitoring System (MPSMS). EHR collects data on regular skin evaluations performed by nurses during admissions of patients and at their transfers, periodically throughout their stay. The EHR offers a complete framework that encourages nurses to track the HAPU stage, size, position, risk evaluation, and diagnosis (Song et al., 2021). MPSMS records cases of pressure-related injuries that happen despite efforts to prevent them.

The organization discovers data about HAPU signs, such as their position, size, and severity, and also data on employing established evaluation tools.  Moreover, the MPSMS identifies patterns and areas for advancement in nursing care. This approach is intended to track and report any novel HAPU cases or previously reported HAPUs that worsen during hospitalization (Eldridge et al., 2022). After collecting the data, my organization uses web-based dashboards and data analysis tools to enable personnel to monitor HAPU criteria in real time, improving transparency in evaluating performance. The organizations gather information on variables that contribute to HAPU development, like immobility and nutritional deficiencies (Marufu et al., 2021). 

Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Interdisciplinary teams evaluate the patient’s health information in EHR. The evaluation includes nursing data documentation, doctors’ updates, and wound healing guidelines. The team examines the data to gather information on HAPU history, therapy protocols, and risk evaluations. The collected information is subsequently communicated through several channels, including quality enhancement reports, discussions or presentations, and training sessions. These reports are distributed to multidisciplinary groups and management to increase awareness, track trends, and promote advancement activities. Furthermore, the health organization has built feedback channels to guarantee that nurses receive practical information from the data, enabling ongoing enhancement in patient care procedures (Getie et al., 2020).

Nurses have numerous critical responsibilities in precisely documenting and avoiding HAPUs, and ensuring high-quality outcomes. For instance, nurses are in charge of performing extensive skin evaluations. Their concentration guarantees that patients are correctly examined and that findings are adequately reported in nursing records (Song et al., 2021). They provide precise data collection and safe, personalized care by adhering to defined protocols and EBP for HAPU mitigation and surveillance.

Nurses’ precise data recording aids in prompt assistance, efficient therapy planning, and enhanced ongoing patient safety and care and safety. Moreover, Nurses must work with multidisciplinary groups to ensure vital data is adequately recorded and conveyed among the team. Furthermore, they accurately report incidences to EHR or MPSMS and participate in debates about mitigation approaches. Alshahrani et al. (2021), state that nurses engage in quality enhancement efforts to offer input on the treatment of HAPU patients assist with gathering and analyzing data, and apply EBP to enhance patient outcomes.

Interprofessional Team and Data Collection and Reporting

The interprofessional team includes nurses and doctors, IT experts, data analyst staff, and quality assurance staff responsible for gathering and reporting data on HAPUs. Their function is critical in improving patient safety, standard of treatment, and organizational success. Everyone on the team brings particular expertise to guarantee extensive care and precise data gathering and distribution. For instance, nurses perform skin examinations, document results in EHRs, and execute preventive actions. Their documentation’s validity, accuracy, and punctuality are critical as it form the basis for quality enhancement reporting, impacting the standard of care and patient safety (Alshahrani et al., 2021). Clinicians offer clinical monitoring and direction, providing essential information about diagnosis, outcomes, and therapies.

They evaluate and verify the nursing records, particularly in challenging or crucial situations. These experts work together to precisely record clinical procedures, patient evaluations, and safeguards to discover areas for development, promoting care quality (Aningalan et al., 2023). IT experts are liable for monitoring the performance of EHR and MPSMS systems, ensuring that they are secure and straightforward to use to enable precise data recording, availability, and reporting. Data analysts examine HAPU data, observe trends, and provide reports to help the Quality assurance staff and leadership make decisions.

Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Lastly, the quality assurance team designs and executes solutions based on research findings that minimize HAPU and improve the standard of care. Interprofessional collaboration contributes to gathering data to improve patient safety by recognizing and reducing risks and enhancing care using EBP. Collaboration aids in informing performance reports of organizations with accurate, practical information, promoting ongoing advances in HAPU care and patient outcomes (Mansour et al., 2020).

Healthcare Organizations Use of Nursing-Sensitive Quality Indicators

The interview was conducted with the head of a quality assurance department, who has expertise in using technology like EHR to collect and report the QI data at my organization. This interview provided a deep understanding of approaches and tools to gather and distribute data. It highlighted the significance of collecting data related to the HAPU rate to improve the standard of care. The interviewee gathered data on the HAPU rate, which is crucial for new nurses to be familiar with in order to analyze the issue’s significance and evaluate nursing practices.

This familiarity enables nurses to deliver proactive care, promoting patient safety. Medical organizations employ data from NSQIs, particularly HAPUs, to ensure patient safety and improve medical outcomes and productivity for stakeholders and executives. These indicators are vital benchmarks that demonstrate the impact of nursing practice on patient results, security, satisfaction, and experience (Oner et al., 2021). 

Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

NSQI is essential for organizational productivity reporting, safety dashboards, and legislative reports. The data collected on NSQI, especially HAPU, is critical for internal efficacy, performance appraisals, and regulatory compliance. Health systems can benchmark against standards to enhance organizational performance reporting and the level of patient care with time, which can help them achieve accreditation and fulfill regulatory requirements (Seiffert et al., 2020). Accountability and openness in care improve an organization’s credibility and reputation by facilitating planning and allocating resources for quality advancement measures.

Furthermore, data on HAPU provides insights into the patterns and efficacy of present organizational proactive efforts (Aningalan, 2023). This data enables executives and leaders to analyze and address root issues like insufficient staff. It advocates adopting EBP and training medical staff about HAPU management and avoidance to enhance patient outcomes. With reliable and precise tracking of HAPU rates, medical facilities can quickly identify vulnerable patients and respond with EBP to improve their safety (Oner et al., 2021). This preventive practice helps reduce the development of HAPUs and linked issues like extended hospitalizations and boosts patient safety.

Evidence-Based Practice Guidelines for Nurses to Use Technologies

HAPU, as an NSQI, is crucial in producing data-driven guidelines for nurses to use patient care technology to offer safe care, improving patient satisfaction and results. NQSIs are critical for establishing EBP standards for medical practices and therapeutic technology, including HAPU management and prevention. For example, EHRs allow nurses to document and track patient skin examinations and treatments systematically. By assessing the lack of adequate patient evaluations or invalid records regarding HAPU, NSQI aids hospitals in integrating HAPU risk evaluation tools like the Braden Scale and the Waterlow Scale into the EHR (Araujo et al., 2020).

This data and technological integration offer immediate information, allowing clinicians to make rapid and educated decisions. NSQIs offer standards for nurses to recognize susceptible patients and promptly execute preventive actions. This NSQI offers guidelines for nursing practice utilizing pressure-sensing technologies like mattresses or portable tools. Stress-sensing mattresses disperse pressure to avoid ulcer growth. Wearable and portable sensors notify nurses when patients require reposition. These tools, based on EBP guidelines, ensure that care is efficient, reducing the HAPU rate (Javid et al., 2023).

Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

NQSI contributes to boosting patient satisfaction, well-being, and quality of life. For instance, it supports the establishment of therapeutic targets for HAPUs. It comprises lowering the risk of wounds, managing medical issues, improving wound healing, and addressing associated concerns. The treatment strategy is designed in response to EBP guidelines due to the high rate of HAPU as NSQI. The non-contact Pressure Ulcer Monitoring Platform (PUMP) system tracks patient movement. It was created in response to evidence of the HAPU rate (Minteer et al., 2020). This NSQI helps nurses identify patients at risk and promptly relocate them. To employ these devices, nurses can follow protocols based on EBP, enhancing patient safety and outcomes. Integrating this technology into their nursing practices enables them to offer proactive, precise, and personalized service, promoting patient satisfaction and outcomes.

Conclusion

In conclusion, NSQIs, including HAPUs, are critical in improving safety, quality of care, and productivity in medical organizations. By closely monitoring HAPU rates and using EBP, medical facilities can continually enhance care provision and patient outcomes. Through interprofessional collaboration, technology incorporation, and research, caregivers can offer practical EBP care to improve the standard of treatment and patient satisfaction. 

References

Alshahrani, B., Sim, J., & Middleton, R. (2021). Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. Journal of Clinical Nursing, 30(15-16), 2151-2168. https://doi.org/10.1111/jocn.15709

Alshammari, S. M. K., Aldabbagh, H. A., Al Anazi, G. H., Bukhari, A. M., Mahmoud, M. A. S., & Mostafa, W. S. E. M. (2023). Establishing standardized nursing quality sensitive indicators. Open Journal of Nursing, 13(8), 551-582. https://doi.org/10.4236/ojn.2023.138037

Aningalan, A. M. (2023). Driving hospital-acquired pressure injuries to zero: A quality improvement project. Advances in Skin & Wound Care, 36(11), 1-6. https://doi.org/10.1097/ASW.0000000000000056

Araujo, S. M., Sousa, P., & Dutra, I. (2020). Clinical decision support systems for pressure ulcer management: Systematic review. Journal of Medical Internet Research Medical Informatics, 8(10), e21621. https://doi.org/10.2196/21621

Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Eldridge, N., Wang, Y., Metersky, M., Eckenrode, S., Mathew, J., Sonnenfeld, N., & Krumholz, H. M. (2022). Trends in adverse event rates in hospitalized patients, 2010-2019. Journal of American Medical Association, 328(2), 173- https://doi.org/1830.1001/jama.2022.9600

Gedamu, H., Abate, T., Ayalew, E., Tegenaw, A., Birhanu, M., & Tafere, Y. (2021). Level of nurses’ knowledge on pressure ulcer prevention: A systematic review and meta-analysis study in Ethiopia. Heliyon, 7(7). https://doi.org/10.1016/j.heliyon.2021.e07648

Getie, A., Baylie, A., Bante, A., Geda, B., & Mesfin, F. (2020). Pressure ulcer prevention practices and associated factors among nurses in public hospitals of Harari regional state and Dire Dawa city administration, Eastern Ethiopia. PLoS One, 15(12), e0243875. https://doi.org/10.1371/journal.pone.0243875

Javid, S. S., Christila, S. S., Akshaya, M., Haritha, R., & Sanjay, P. (2023). Technology-assisted pressure ulcer prevention: The automatic mattress. International Journal of Health Technology and Innovation, 2(02), 16-23. https://doi.org/10.60142/ijhti.v2i02.03

Mansour, L. A., Dudley-Brown, S., & Al-Shaikhi, A. (2020). Development of an interdisciplinary healthcare team for pressure injury management: A quality improvement project. Journal of Wound Ostomy & Continence Nursing, 47(4), 349-352. https://doi.org/10.1097/WON.0000000000000652

Capella 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Marufu, T. C., Setchell, B., Cutler, E., Dring, E., Wesley, T., Banks, A., Chatten, M., Dye, E., Cox, S., Boardman, R., Reilly, L., & Manning, J. C. (2021). Pressure injury and risk in the inpatient paediatric and neonatal populations: A single centre point-prevalence study. Journal of Tissue Viability, 30(2), 231–236. https://doi.org/10.1016/j.jtv.2021.02.004 

Minteer, D. M., Simon, P., Taylor, D. P., Jia, W., Li, Y., Sun, M., & Rubin, J. P. (2020). Pressure ulcer monitoring platform—a prospective, human subject clinical study to validate patient repositioning monitoring device to prevent pressure ulcers. Advances in Wound Care, 9(1), 28-33. https://doi.org/10.1089%2Fwound.2018.0934

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing‐sensitive indicators for nursing care: A systematic review (1997–2017). Nursing open, 8(3), 1005-1022. https://doi.org/10.1002/nop2.654

Seiffert, L. S., Wolff, L. D. G., Ferreira, M. M. F., Cruz, E. D. D. A., & Silvestre, A. L. (2020). Indicators of effectiveness of nursing care in the dimension of patient safety. Revista Brasileira de Enfermagem, 73, e20180833. https://doi.org/10.1590/0034-7167-2018-0833

Song, W., Kang, M. J., Zhang, L., Jung, W., Song, J., Bates, D. W., & Dykes, P. C. (2021). Predicting pressure injury using nursing assessment phenotypes and machine learning methods. Journal of the American Medical Informatics Association, 28(4), 759-765. https://doi.org/10.1093/jamia/ocaa336

VanGilder, C. A., Cox, J., Edsberg, L. E., & Koloms, K. (2021). Pressure injury prevalence in acute care hospitals with unit-specific analysis: Results from the International Pressure Ulcer Prevalence (IPUP) Survey database. Journal of Wound Ostomy & Continence Nursing, 48(6), 492-503. https://doi.org/10.1097/WON.0000000000000817

Yu, S. Y., Ullrich, P. J., Weissman, J. P., Joshi, C. J., Taylor, R., Patel, A., & Galiano, R. D. (2022). Evaluation of Altrazeal transforming powder dressing on stage 2–4 pressure ulcers: A clinical case series. Journal of Wound Care, 31(Sup5), S6-S12. https://doi.org/10.12968/jowc.2022.31.Sup5.S6