Best Practices – Assessing Nurse-Sensitive Quality Information

Best Practices – Assessing Nurse-sensitive Quality Information
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July 1, 2021
Understanding the various indicators of the quality of health provision in the workplace is essential for any nursing professional. It allows him to better grasp the organization's overall performance and any opportunities for improvement in the future. In this article, the author would like to focus on the Nurse-sensitive Quality Indicators (NDNQI) provided in the case of Dr. Rempher and Ms. Manna. Upon a review of the various indicators provided in the dashboard, the author believes that one of the opportunities for improvement lies in the part of 'Patient Falls,' which is coded as 'TOTFALLS.' This indicator accounts for the percentage of the total number of falls within the organization for a period of 1000 days. Subsequently, the following chapters would provide how this issue on the high rates of falls could be improved in relation to other indicators such as the development of pressure ulcers and Risk of Falls and On-fall protocols. All in all, the author believes that by improving this nursing indicator and assessing its statistical and actual significance, it becomes possible to improve performance within this framework.   Assessing Nursing Indicators As stated earlier, the dashboard shows that the 'Total Number of Falls' within the organization was one of the potential areas of improvement. On the one hand, reducing the number of falls in the provision is care is crucial since falls can increase the time needed for recovery, costs of hospitalization, and even the overall perception of the quality and efficacy of care of the organization (Bowden, Bradas, & McNett, 2019). On the other hand, mitigation of fall cases is also essential, especially for high-risk cases, which can be aggravated by falls. This includes geriatric patients who have weaker bones, patients recovering from fractures, and those who are taking blood thinners, which could cause severe and irreversible damage (Center for Disease Control and Prevention, 2017). In terms of the data provided in the dashboard, it could be seen that the Mean (x-hat) values of the number of falls were significantly higher as compared to the Target values per quarter. In each of the four quarters observed, the mean deviates from the target value by around 3 to 4, indicating the high chances of falls within the organization. Accordingly, the total number of falls within the duration could be seen in line with the At-Risk and On Fall protocol. This metric shows the number of patients who are at risk of falls. However, this data also shows that the mean number of patients is significantly higher than the target value of 100%. Finally, it seems that another quality indicator that must be addressed in relation to fall reduction in the development of pressure ulcers (%PRSSULC). Similar to what was provided above, the dashboard suggests that the number (represented by the mean) of patients developing pressure ulcers is significantly higher than the target values. Accordingly, since the reduction of pressure ulcers through 'repositioning' also increases the risks of falls, these must be taken into consideration in the development of fa...