National Database of Nursing Quality Indicators (NDNQI) Essay Papers

Reply to 2 peers and provide them each with a potential or actual study using  a mixed method design to address their practice challenge.  Be sure to provide citations.

For week 2, you will add the following content to your formal literature synthesis based on the practice challenge you described last week.

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1.  Define problem statement, hypothesis, and PICOT statement. Cite resources

A problem statement is developed by the researcher and identifies a potential problem that is relevant to practice. A hypothesis is a fundamental explanation based on limited data and observation that serves as a foundational starting point with which to proceed with further investigation.

PICOT stands for Population (P), Intervention (I), Comparison (C), Outcome (O) and Time-frame (T) of intervention. A PICOT statement is a reliable “formula” for producing answerable, researchable questions (Polit& Beck, 2017).

2.  Develop a problem statement, potential hypothesis, and potential PICOT statement based on your practice challenge.

Nursing staff shortages impact patient care as well as the nurses who provide the patient care. Nurse staffing needs vary depending on acuity, day or night shift, procedures, and any number of unforeseen events. Short staffing jeopardizes not only the patients but the license and health of the nurses as well.

A potential hypothesis regarding this topic may be that if nursing staffing was improved, the occurrence error related patient incidences. The population affected in this PICOT statement is the patients. The intervention in this PICOT statement is that the nursing staffing levels can be increased to alleviate the shortages. The comparison will be a hospital that remains at lower staffing levels.

The outcome will be the number of nurse retention compared in both hospitals. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. The comparison time will be one year.

3.  Identify potential (ones you make up) or actual studies using 2 different methodologies (qualitative and quantitative). Be sure to provide citations. 

A qualitative study that evaluates the patient effects of nurse short staffing is study performed by Clark, P. A., Leddy, K., Drain, M., &Kaldenberg, D. “state nursing shortages and patient satisfaction: more RNs—better patient experiences” (2007). In this study, the do a qualitative analysis on the quality of patients care and the correlation between adequate nursing staffing.

A quantitative study that evaluates the patient effects of nurse short staffing is “nurse staffing and patient outcomes: a longitudinal study on trend and seasonality by He, J., Staggs, V. S., Bergquist-Beringer, S., &Dunton, N. (2016).

In this study He performed a longitudinal study based off quarterly unit-level nursing data in 2004–2012 were extracted from the National Database of Nursing Quality Indicators (NDNQI).

Second Post

The opioid misuse and abuse has become an epidemic nationwide. There has been a 30 percent increase in overdoses in the U.S. from July 2016 through September 2017.

(Centers for Disease Control and Prevention, 2018) To be able develop a solution for this epidemic, the problem must be identified. To identify the issue, a problem statement and hypothesis needs to be created. This will better identify the problem and study the cause behind the issue.

“A problem statement presents the idea, issue, or situation that the researcher intends to examine in the study” (Trice & Bloom, 2015 p. 128). National Database of Nursing Quality Indicators (NDNQI) Essay Papers. The problems statement sets the foundation for the researcher. To further describe the problem statement, the PICOT format is used to clarify “more fully the population of the study as well as the intervention/comparison of interest, the outcome desired, and the time framed involved” (Trice & Bloom, 2015 p. 130).

PICOT format stands for P) population of the subjects in the study I) treatment that will be provided in the study C) comparison of the control group to the one in the study O) outcome that is being measure to test the effectiveness of the intervention T) time; the duration of the data collection. (Riva, Malik, Burnie, Endicott, &Busse, 2012)

Along with a problem statement, a hypothesis is needed to put a “question into a form that can be tested” (Trice & Bloom, p. 134). A hypothesis will allow the researcher to make a proposition regarding the issue pertaining to the problem statement chosen.

Problem statement: The opioid epidemic is costing thousands of American lives annually.

Hypothesis: If a person is started on narcotics at an earlier age than 21 years, they are more likely to be addicted to narcotics than those not started after 21 years of age.

PICOT:

1. P) Population: addicts; those addicted to narcotics
2. I) Intervention: safe prescribing (not prescribing narcotics under the age of 21)
3. C) The difference between addicts who received narcotics before the age of 21 vs the addicts who were given narcotics after age 21.
4. O) fewer addicts and overdoses
5. T) time of my data collection

The Centers for Disease Control and Prevention(CDC) analyses data using the National Vital Statistics System (NVSS). The CDC “combined the natural, semi-synthetic, and synthetic opioid categories (including methadone) when reporting deaths involving opioid analgesics, also referred to as prescription opioids” (Centers for Disease Control and Prevention, 2017).

In 2016, there has been 32,445 reports deaths involving opioids, averaging 89 deaths per day. From 2015, reported deaths have increased by 9,847 annually. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. A large amount of these deaths are not correlated with prescription opioids but to illegally-made fentanyl. The NVSS data does not differentiate between prescription drugs and illegally-made.

“Every ‘Never’ I Ever Said Came True”: Transitions from opioid pills to heroin injecting is a qualitative study “documents the pathways to injecting heroin by users in Philadelphia and San Francisco before and during a pharmaceutical opioid pill epidemic” (Mars, Bourgois, Karandinos, Montero, &Ciccarone, 2014). Data was collected by interviewing the drug dealers and observing the addicts behavior.

The study include Philadelphia and San Francisco due to the “contrasting political economies, immigration patterns and source type of heroin” (Mars, Bourgois, Karandinos, Montero, &Ciccarone, 2014). National Database of Nursing Quality Indicators (NDNQI) Essay Papers. It was determined in this study that heroin users in both cities began using heroin after they became addicted to prescription pills. They switches to heroin due to the availability being more accessible.

Informatics and Nursing Sensitive Quality Indicators

The sprouting interest in the involvement of evidence-based nursing care in patient care has resulted in the insistence and appreciation of the value of nursing care. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. Similarly, the desire for efficiency in the health care industry has led to considerable alterations in the structure and processes of the healthcare environment (Mangold & Pearson, 2017).

These changes include the development of nursing-sensitive quality indicators as well as electronic health records. Integration of the aforementioned alterations has been associated with improved patient outcomes and safety. This piece of writing will extensively describe a selected nursing-sensitive quality indicator, explore its importance, assess the collection and dissemination of its data. Finally, the paper will correlate the role of nurses in nursing informatics and the impact of patient care technologies.

National Database of Nursing Quality Indicators

The National Database of Nursing Quality Indicators (NDNQI) is fundamentally a database that furnishes quarterly and annual reporting of the process, structure, and outcome indicators to assess nursing care at the unit level (Oner et al., 2021). NDNQI establishes the correlation between nurse staffing and patient outcome by periodically gathering data and reporting.

Subsequently, the database assists the nurse in quality improvement and patient safety strives by supplying research-based national, relative data on nursing care and its relationship to patient outcomes (Oner et al., 2021). Ultimately, NDNQI assembles a stretching body of knowledge on nursing aspects that influence patient outcomes.

Nursing-Sensitive Quality Indicators

Nursing-sensitive quality indicators refer to the criteria for changes in health status that can be directly affected by nursing care (Oner et al., 2021). These indicators can be categorized broadly as structural, process, and outcome indicators. Structural indicators include but are not limited to nurse turnover, nursing hours per patient per day, skill mix, and RN education.

Meanwhile, process indicators assess methods of patient assessment, nursing interventions as well as career satisfaction of the nursing staff. Lastly, outcome indicators include patient outcomes such as patient falls and pressure ulcers that are largely dependent on the quantity and quality of nursing care. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. For this piece of writing, patient falls, an outcome-based indicator shall be the selected quality indicator.

Why Is This Quality Indicator Important to Monitor?

Patient falls are among the most serious issues that considerably contribute to disability. It is most prevalent in the elderly with an estimated prevalence of 30% in individuals over 65 years of age annually (LeLaurin & Shorr, 2019). Subsequently, it is imperative to monitor this indicator as its prevalence directly correlates with the quality of nursing care. A multitude of risk factors including impairment in balance, polypharmacy, visual problems, depression, diminished muscle strength, and pain predisposes one to falls.

Thus, monitoring of this indicator pivotally aids in early recognition of these risk factors and the institution of prompt preventive measures. Falls are a threat to patient safety due to their devastating outcomes including fractures, pain, bruising, disability, impaired physical activities and activities of daily living, and intracranial bleeding.

It is therefore elemental to monitor this indicator to attenuate the aforementioned threats. Furthermore, falls in hospitalized patients are associated with poor health-related quality of life, prolonged hospital stays, increased cost of hospitalization, and increased rate of hospital readmissions (LeLaurin & Shorr, 2019). Thus, monitoring of falls improves patients’ satisfaction and safety.

New nurses need to be familiar with this indicator because it is a mirror image of the quality of nursing care. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. Similarly, the new nurses should familiarize themselves with this indicator to develop effective prevention programs and strategies through early recognition and assessment of the risk factors that escalate this condition.

Additionally, knowledge of falls and their prevention is consistently changing with the evolution of new and effective methods of fall prevention methods such as comprehensive geriatric monitoring, and thus it is elemental for the novice nurse to get acquainted. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. Finally, the new nurses should recognize this indicator to significantly increase their expertise by learning complex fall prevention interventions.

Collection and Distribution of Quality Indicator Data

According to your interview and other resources, how does your organization collect data on this quality indicator?

I interviewed the head nurse of the surgical department in my organization. Concerning the gathering of data for this indicator, the head nurse distributes two questionnaires monthly. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. The first questionnaire is filled by the patient while the second questionnaire is filled by the nurses.

The patient-filled questionnaire gives feedback about the quality of nursing, the events leading to a fall, any possible risk factors and injuries sustained. The nurse-based questionnaire provides detailed information on the number of falls, the time they occurred, risk factors, and interventions in place prior to occurrence.

The nurse-based questionnaire is usually emailed to staff at various departments while the patient questionnaire is paper-based. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. Finally, each unit in the facility has an excel spreadsheet for recording every fall upon its occurrence.

The challenges encountered during this data collection process include incomplete and inaccurate filling of the questionnaires, especially by the patients. Additionally, with email, some of the nurses forget or rather accidentally delete the emails. Nevertheless, the data collected from the surveys are entered into a patient fall electronic record, compiled, and analyzed before dissemination.

How does the organization disseminate aggregate data?

The aggregated data is monthly distributed to all head nurses to share with their nursing staff through their emails as well as a printed copy. Similarly, the quarterly combined and analyzed data is shared during the quarterly fall prevention meetings. However, the information is kept private and only shared with the involved parties.

The head nurse further highlighted the elemental role of the information provided, “As an institution, the information from the surveys helps us to determine the trends, evaluate the quality of nursing care and develop strategies for effective fall prevention.” National Database of Nursing Quality Indicators (NDNQI) Essay Papers.

What role do nurses play in supporting accurate reporting and high-quality results?

The nurses play a critical role in facilitating accurate reporting and high-quality results. First and foremost, they guide the patients while filling their questionnaires to ensure the questionnaires are fully and accurately filled. In addition to the nurses filling the nurse-based questionnaire, they promptly record every fall, compile individual data and transfer it to patient fall electronic record. Finally, they contribute to the analysis of data in their various departments.

Role of Nurses and Interdisciplinary Team in Informatics

Nurses and interdisciplinary teams play a vital role in nursing informatics. For instance, the nurses and interdisciplinary teams work interactively to continuously improve and develop healthcare technology. This process of improvement encompasses staff tracking, workflow, and communication as well as prompt monitoring of patient initiatives.

Similarly, nurses together with the interdisciplinary team members collect and analyze vital information for electronic health records which is utilized to make treatment decisions and other clinical decisions (Farokhzadian et al., 2020) National Database of Nursing Quality Indicators (NDNQI) Essay Papers.

Furthermore, the interdisciplinary team and nurse informatics train other nursing staff on how to use and implement information technology to collect, research and evaluate the quality of data related to nursing-sensitive quality indicators.

The interdisciplinary team and nurses further guide new technology and process implementation as well as provision of feedback on which areas require improvement. Consequently, a more effective and efficient electronic health information system is established that enhances quality nursing care, patient safety, and patient satisfaction.

Impact of Patient Care Technologies on Desired Outcomes

Electronic health information facilitates improved documentation of quality indicators as well as easy retrieval of data. A great deal of documentation is real-time as the patients are connected with various devices that collect information instantaneously and transmit it to the electronic patient health record. This improves the quality of patient care and safety through continuous monitoring and faster decision-making (Farokhzadian et al., 2020).

Moreover, patient care technologies are precise and provide accurate quality indicator information through alignment of nursing best practices and clinical workflow resulting in more improved patient care. National Database of Nursing Quality Indicators (NDNQI) Essay Papers. Patient care technologies have also advanced diagnostic and therapeutic options through their sophisticated equipment which has improved treatment outcomes (Farokhzadian et al., 2020).

Similarly, technologies have significantly reduced medication errors associated with nursing care which reduces the overall cost of care. Finally, patient care technologies have enhanced training as well as proper continuity of care through the development of protocols and processes that ensure effective communication (Farokhzadian et al., 2020).

I recommend the utilization of technology to enhance patients’ safety. Embracing technology in the collection and assessment of information regarding nurse-sensitive quality indicators improves the effectiveness of this process which provides the fundamental principles for developing evidence-based practice.

For instance, the gathering of information on quality indicators and their subsequent analysis can be equilibrated to research as the results obtained can be used by the organization to formulate and make decisions that improve patient care.

Conclusion on National Database of Nursing Quality Indicators (NDNQI) Essay Papers

Nurse-sensitive quality indicators provide a quantitative and qualitative assessment of nursing care. Patient care technologies should be incorporated while gathering the information on various aspects of quality indicators to enhance patient safety and desired outcomes as well as evidence-based nursing practice.

References for National Database of Nursing Quality Indicators (NDNQI) Essay Papers

• Farokhzadian, J., Khajouei, R., Hasman, A., & Ahmadian, L. (2020). Nurses’ experiences and viewpoints about the benefits of adopting information technology in health care: a qualitative study in Iran. BMC Medical Informatics and Decision Making, 20(1), 240. https://doi.org/10.1186/s12911-020-01260-5
• LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: State of the science. Clinics in Geriatric Medicine, 35(2), 273–283. https://doi.org/10.1016/j.cger.2019.01.007
• 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
• 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