NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Sample Answer for NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators Included After Question

Prepare an 8-10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.

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

A Sample Answer For the Assignment: NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Title: NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

The delivery of quality healthcare is the main aim of any healthcare organizations. Quality care contributes to the realization of outcomes of care that include patient satisfaction, empowerment, adherence to treatment, and reduction of healthcare costs. The ability of nurses and healthcare organizations to deliver quality care depends largely on their focus on quality indicators. Quality indicators reflect a number of aspects in nursing that include process, outcome and structural indicators

. The realization of the developed sensitive or quality indicators in an organization implies that the outcome, process and structural processes are effective in the organization. Therefore, this presentation examines a selected nursing-sensitive quality indicator and its related aspects that include NDNQI, nursing sensitive quality indicators, importance of the selected indicator and collection of data related to it.

NDNQI and Nursing Sensitive Quality Indicators

The NDQI is a national database that was established for the collection of nursing quality indicators. The nursing quality indicators provide insights into the quality of nursing care given in different health organizations in the state. The American Nurses Association developed NDNQI in 1998 with the aim of developing knowledge in nursing about the factors that are critical in influencing the quality of nursing care to the patients. One of the goals of NDNQI is to develop national data that can be used to measure the relationship between patient outcomes and nurse staffing (Arnold-Long et al., 2018). The other goal of the NDQI is to provide the participant hospitals with the national comparative data of the nursing sensitive indicators for quality improvement initiatives.

As noted above, nursing sensitive quality indicators are sources of data that provide information about the structure, patient and process outcomes of nursing care. The structure outcomes in nursing include aspects such as knowledge and skills of the staffs, education and professional development of the staffs and supply of the nursing staff. Process outcomes focus on the interventions that are used to achieve the desired outcomes of care, job satisfaction level of the staffs and the effectiveness of the organizational processes utilized in the delivery of care. Outcomes focus on aspects such as the realization of the objectives of patient care. An improvement or realization of outcomes of care provides insights into the effectiveness of the adopted process interventions.

The nursing sensitive quality indicators that are monitored in the NDQI are varied. They include nursing hours in a patient day, nursing turnover rate, nosocomial infections, patient falls, patient falls with injuries, pressure ulcer rate, pediatric pain assessment, pediatric peripheral intravenous infiltration, registered nurses survey, registered nurses’ education, restraints, and staff matrix (Ju et al., 2018; Koch et al., 2020). Hospitals that are members of the NDQI are expected to voluntary provide data on these sensitive data to guide the implementation of quality improvement initiatives and evidence-based practice initiatives in nursing.

Selected Quality Indicator

The selected quality indicator for focus in the presentation is urinary catheter associated urinary tract infections (UTIs). According to evidence, catheter-associated urinary tract infections are among the most common hospital acquired infections in America. The evidence provided by Podkovik et al., (2019), the estimated number of cases of catheter-associated urinary tract infections in the US hospitals in 2011 was two cases in every 1000 hospital indwelling catheter days. Patients who develop catheter-associated urinary tract infections present with symptoms that include fever, costovertebral angle tenderness, suprapubic tenderness, dysuria, urinary frequency, and presence of bacteria or white blood cells on urine culture (Kuy et al., 2020).

Patients with indwelling urinary catheter are highly predisposed to urinary tract infections due to a number of factors. One of the factors is the prolonged use of indwelling urinary catheter that predisposes the urinary tract to colonization by bacteria. Improper use of aseptic techniques or preparation for insertion also increases the risk for the development of catheter-associated urinary tract infections (Letica-Kriegel et al., 2019; Omer et al., 2020). The additional risk factors for catheter-associated urinary tract infections include female gender, poor nutrition, severe illness, fecal incontinence, and immunosuppression (Anggi et al., 2019).

Cather-associated urinary tract infections are included in the nursing sensitive quality indicators because they are preventable. Accordingly, appropriate interventions can be adopted in health institutions to prevent them. Examples of interventions that can be embraced in nursing to reduce the infections include appropriate insertion of the urinary catheter, reducing the colonization of bacteria around the urethral area of meatus using antiseptic cleaning solutions, and instituting institutional guidelines and policies that relate to insertion of urinary catheter (Mitchell et al., 2017). Consequently, it is important that new nursing staffs be educated on the factors that contribute to catheter-associated urinary tract infections and ways of minimizing them in practice.

Importance of Monitoring the Indicator

Monitoring catheter-associated urinary tract infections in nursing is important because of a number of reasons. Firstly, the rates of catheter-associated urinary tract infection in an organization indicate the quality and safety of care given to the patients. A high rate of catheter-associated urinary tract infections in an institution implies that the nurses do not possess knowledge and skills that are needed to promote safety in patient care. Catheter-associated urinary tract infections are also monitored due to the adverse health effects that they have. According to evidence, catheter-associated urinary tract infections cause complications that include endocarditis and sepsis. This type of infection is also reported to contribute to more than 13000 deaths every year across the world (Podkovik et al., 2019). Patients affected with catheter-associated urinary tract infections also stay in hospital longer than those who do not develop the infection. The extended hospital stay is attributed to the additional treatment that patients should receive to prevent complications. Extended hospital stay implies that the cost that the patients incur due to catheter-associated urinary tract infections is high (Kuy et al., 2020).  

According to the study by Hollenbeak and Schilling (2018), catheter-associated urinary tract infection costs patients and health organizations $876 for additional medications and diagnostic tests. The authors also show that Medicare cost for inpatient costs for non-intensive care unit is $1764 and $8398 inpatient cost for pediatric patients and $10197 for ICU patients (Hollenbeak & Schilling, 2018). According to Mitchell et al., (2017), 380000 bed days are lost on an annual basis in Australia due to catheter-associated urinary tract infections and extended hospital stay. Therefore, considering the above impacts, nurses should be educated on the best practices that are effective in preventing and reducing the rates of catheter-associated urinary tract infections.

Why Nurses need to be Aware of the Quality Indicator

New nurses need to be familiar with catheter-associated urinary tract infection as a quality indicator because they play a critical role in preventing its occurrence. Insertion of urinary catheter is the primary role of nurses in hospital settings. This implies that they play a critical role in the adoption of best practices that minimize the risk of the infections. New nurses also need to be familiar with the indicator because they lead quality initiatives to improve the quality of care in their institutions. Nurses spend most of their time in hospitals with their patients. As a result, they must be involved in quality improvement initiatives since they have critical inputs on the interventions that must be adopted to improve care. Lastly, new nurses play a role in implementing evidence-based practice interventions. Consequently, they should be familiar with catheter-associated urinary tract infection for them to explore the available evidence-based data that can be implemented in their place of work to improve the quality and safety of care.

Collection and Distribution of Indicator Data

The data on catheter-associated urinary tract infections is collected using a number of approaches in the institution. One of them is the extraction of data on catheter-associated urinary tract infections from laboratory data. Laboratories in the institution post their results through the electronic health records system where the data on urinary tract infections for patients with indwelling catheter is extracted and stored in the repository for incidents in the organization. The other way in which the data is collected is through nurses and physicians entering incident reports of catheter-associated urinary tract infections into the hospital system for incidence reports and adverse events. The collected data is pooled in a system that is then used for the analysis of the data and generation of detailed reports on the infection rate.

In addition, the hospital sends the data on a monthly basis to the NDQI where the data is captured for comparative analysis purposes. The organization disseminates the data on catheter-associated urinary tract infections by developing detailed reports that is shared with the healthcare providers. Monthly meetings are held to share the information on the quality indicators, success and areas of improvements in the hospital. Through it, the healthcare providers are informed about the effectiveness of the interventions that are utilized to improve the quality of care given to the patients.

Role of Nurses

Nurses play an important role in ensuring accurate reporting and high-quality results. Nurses ensure timely reporting of incidents of catheter-associated urinary tract infections. Nurses also ensure that the details about the patient-data are accurately entered into the system for reporting incidents. Nurses also guide new nurses in the accurate reporting of catheter-associated urinary tract infections. They ensure that the new nurses understand the practices that support accurate data reporting and high-quality results. Through these interventions, nurses ensure that the data that is reported depict the quality as well as safety of the care that patients with indwelling urinary catheter receive in the institution.

Conclusion

Quality indicators play an important role in nursing. Quality indicators provide data that can guide nursing research. Nurses can use information from quality indicators to implement interventions that will enhance the safety and quality of care given to patients. Catheter-urinary tract infections are one of the quality indicators in nursing. Catheter-associated urinary tract infections have adverse health effects on the patients and health organizations as a whole. New nurses should be educated about this indicator to create awareness among them on the importance of utilization of best practices to reduce its incidence rate. Health organizations should encourage accurate reporting of quality indicators to ensure that quality improvement initiatives that are embraced target at enhancing performance in prioritized areas of service provision.

References

Anggi, A., Wijaya, D. W., & Ramayani, O. R. (2019). Risk Factors for Catheter-Associated Urinary Tract Infection and Uropathogen Bacterial Profile in the Intensive Care Unit in Hospitals in Medan, Indonesia. Open Access Macedonian Journal of Medical Sciences, 7(20), 3488–3492. https://doi.org/10.3889/oamjms.2019.684

Arnold-Long, M., Emmons, K., & Chovan, J. D. (2018). Incontinence-Associated Dermatitis and Intertriginous Dermatitis as Nurse-Sensitive Quality Indicators. Journal of Wound, Ostomy and Continence Nursing, 45(3), 221–226. https://doi.org/10.1097/WON.0000000000000427

Hollenbeak, C. S., & Schilling, A. L. (2018). The attributable cost of catheter-associated urinary tract infections in the United States: A systematic review. American Journal of Infection Control, 46(7), 751–757. https://doi.org/10.1016/j.ajic.2018.01.015

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. https://doi.org/10.1111/jocn.14256

Koch, D., Kutz, A., Conca, A., Wenke, J., Schuetz, P., & Mueller, B. (2020). The relevance, feasibility and benchmarking of nursing quality indicators: A Delphi study. Journal of Advanced Nursing, 76(12), 3483–3494. https://doi.org/10.1111/jan.14560

Kuy, S., Gupta, R., Roy, C., & Awad, S. (2020). Incidence of Catheter-Associated Urinary Tract Infections With Compliance With Preventive Guidelines. JAMA Surgery, 155(7), 661–662. https://doi.org/10.1001/jamasurg.2020.0428

Letica-Kriegel, A. S., Salmasian, H., Vawdrey, D. K., Youngerman, B. E., Green, R. A., Furuya, E. Y., Calfee, D. P., & Perotte, R. (2019). Identifying the risk factors for catheter-associated urinary tract infections: A large cross-sectional study of six hospitals. BMJ Open, 9(2), e022137. https://doi.org/10.1136/bmjopen-2018-022137

Mitchell, B. G., Fasugba, O., Gardner, A., Koerner, J., Collignon, P., Cheng, A. C., Graves, N., Morey, P., & Gregory, V. (2017). Reducing catheter-associated urinary tract infections in hospitals: Study protocol for a multi-site randomised controlled study. BMJ Open, 7(11), e018871. https://doi.org/10.1136/bmjopen-2017-018871

Omer, S. A., Zahran, F. E., Ibrahim, A., Sidahmed, L. A., Karam, G., Almulhim, F., & Soltan, S. A. (2020). Risk Factors for Catheter Associated Urinary Tract Infections (CAUTI) in Medical Wards and Intensive Care Units (ICU). Journal of Microbiology Research, 10(1), 1–5.

Podkovik, S., Toor, H., Gattupalli, M., Kashyap, S., Brazdzionis, J., Patchana, T., Bonda, S., Wong, S., Kang, C., Mo, K., Wacker, M. R., Miulli, D. E., & Wang, S. (2019). Prevalence of Catheter-Associated Urinary Tract Infections in Neurosurgical Intensive Care Patients – The Overdiagnosis of Urinary Tract Infections. Cureus, 11(8). https://doi.org/10.7759/cureus.5494