NURS-FPX4040 Assessment 4 Paper

NURS-FPX4040 Assessment 4 Paper

NURS-FPX4040 Assessment 4 Paper

Informatics and Nursing Sensitive Quality Indicators Sample

The quality and quantity of nursing care significantly impact patient outcomes. According to the American Nurses Association (2018 NURS-FPX4040 Assessment 4 Paper), nursing-sensitive quality indicators (NSQI), whether patient outcomes or organizational performance, are aspects of nursing care directly influenced by the quality and quantity of nursing care. NSQI allows for the evaluation of clinical performance, provides a track record, can be used as a comparison measure against other hospitals in the national and state governments, and finally, aids in establishing evidence that improves patient care quality (Wong et al. 2020). Hospital readmission rates, as an NSQI, are extensively elaborated in relation to technology and its application in monitoring NSQIs in the following discussion.

Interdisciplinary Role in Collecting and Reporting NSQI Data to enhance Patient Safety, Outcomes, and Organizational Performance

For the purposes of this discussion, the NSQI chosen is hospital readmission rates. According to the Centers for Medicare and Medicaid Services (2019 NURS-FPX4040 Assessment 4 Paper), hospital readmission rates are defined as admissions to a hospital within 30 days of being discharged from a previous hospital stay. Many factors contribute to high hospital readmission rates, including inappropriate treatment, poor medication adherence, failed home care, poor social planning, and so on. To reduce readmission rates, particularly for chronic diseases such as Diabetes Mellitus (DM), heart failure, and chronic obstructive pulmonary disease (COPD), technology, particularly Telehealth, is used to ensure continuity of care while patients are at home and to bridge the gap between the patient and the hospital. NURS-FPX4040 Assessment 4 Paper

The collection and reporting of NSQI require a well-organized team and systems. Data on patient hospital readmission rates must be collected by an interdisciplinary team comprised of nurses, doctors, the records department, and the health informatics team. Electronic health records (EHR) have simplified data collection by allowing users to enter and organize information in a word or excel documents. The EHR eliminates the documentation burden of the traditional paper-based system while also lowering the risk of errors caused by doctors’ poor penmanship and omissions (Kruse et al., 2018). When a patient is readmitted, the data is entered into the EHR so that at the end of the month, the prevalence of hospital readmission within the previous 30 days can be calculated and compared to other hospitals, and interventions to reduce readmission rates can be designed and implemented.

The data collected is reported at regular intervals, such as quarterly in my institution. Reporting is accomplished by converting data into text, graphs, tables, and scales. For example, in calculating hospital readmission rates, the numerator is the number of patients readmitted within 30 days of admission, while the denominator is the total number of elective and urgent admissions, and the result is converted to a percentage. This percentage is used to compare to previous months’ data as well as data from other hospitals.

The quality indicator impacts the patients’ safety and care, and the organization’s performance. Upadhyay et al. (2019 NURS-FPX4040 Assessment 4 Paper) studied 98 hospitals in Washington State from 2012 to 2014 to see if readmission rates affected patient care, safety, and hospital financial performance. The findings show that readmission of patients puts them at a high risk of nosocomial infections because they are acutely ill and have low immunity during that time, compromising their safety. Furthermore, readmission of patients exacerbates the already existing nurse and physician shortages by resulting in a high patient-nurse ratio. The findings also revealed that the hospital’s financial performance faced a two-pronged outcome: (1) the hospital could either spend more on treating conditions such as acute myocardial infections, reducing operating revenues, or (2) the hospital could generate more revenue by treating so many patients.

How Healthcare Organizations Use NSQI Data to Enhance Patient Safety, Patient Care Outcomes, and Organizational Performance

Since the NSQI are used to assess nursing and clinical performance, they serve as a foundation for tracking patient care outcomes and organizational performance. For example, even though creating readmission charts is time-consuming, the figures are used to compare rates with previous months and with other hospitals. As a result, hospitals strive to reduce readmission rates by implementing strategies to improve patient safety and care outcomes. In a systematic review, Mashhadi et al. (2021 NURS-FPX4040 Assessment 4 Paper) describe the use of post-discharge mHealth and a Teach-Back Communication method to reduce readmission rates. The findings revealed a significant reduction in readmission rates following the use of mHealth technology, in which patients attended scheduled visits with health care providers and received health education on self-management strategies while at home.

In terms of organizational performance, readmission rates can have two effects on the hospital. High readmission rates cause the hospital to incur additional costs for treating the conditions, resulting in low operating revenues (Mashhadi et al., 2021 NURS-FPX4040 Assessment 4 Paper). On the other hand, hospitals could make huge profits from treating readmitted patients, increasing their revenue (Mashhadi et al., 2021). From the preceding explanations, it is clear that NSQI impacts patients and hospitals in various ways, both positively and negatively.

How NSQI Established Evidence-Based Guidelines

In today’s healthcare, it’s impossible to avoid incorporating technology into patient care. Nurses, particularly those with backgrounds in health informatics, play a critical role in ensuring the integration’s success. Because nurses make up the majority of healthcare workers, they actively participate in collecting and reporting NSQI data, which is then used to develop evidence-based guidelines (Ju et al., 2018 NURS-FPX4040 Assessment 4 Paper). For example, in terms of readmission rates, nurses may tabulate or report monthly readmission rates in graphs or textual format. This information is compared to other hospitals in the national or state government. If the hospital’s readmission rates do not meet the target, the hospital will develop strategies and guidelines to improve its performance. Reduced readmission rates can be achieved through policy changes, the use of technology, and the use of medications, among other strategies (Ju et al., 2018). Finally, with increased implementation of readmission-reduction strategies, patient safety, care outcomes, and organizational performance improve more quickly.


In summary, nursing knowledge and practice are constantly changing and being updated, necessitating continuous improvement of knowledge and skills. The use of NSQI is one strategy for broadening the body of nursing knowledge and improving care quality. The hospital readmission chart keeps track of the facility’s monthly readmission rates, and assists care providers and administration in working toward interventions that reduce the rate, improve patient safety and outcomes, and organizational performance. As a result, continuous data collection and reporting of NSQI is important because it contributes to developing evidence-based guidelines to ensure the most current and up-to-date care. NURS-FPX4040 Assessment 4 Paper

NURS-FPX4040 Assessment 4 Paper References

American Nurses Association. (2018). The national database of nursing quality indicators® (NDNQI®). Nursingworld.Org.

Centers for Medicare and Medicare Services. (2019). Hospital Readmissions Reduction Program (HRRP). Cms.Gov.

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.

Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of electronic health records to support population health: A systematic review of the literature. Journal of Medical Systems, 42(11), 214.

Mashhadi, S. F., Hisam, A., Sikander, S., Rathore, M. A., Rifaq, F., Khan, S. A., & Hafeez, A. (2021). Post discharge mHealth and teach-back communication effectiveness on hospital readmissions: A systematic review. International Journal of Environmental Research and Public Health, 18(19).

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission rates and their impact on hospital financial performance: A study of Washington hospitals. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 56, 46958019860386.

Wong, E. Y. H., Chau, L. S., Yu, Y., Leung, R. P. W., Lai, P. C. K., Lo, J. W. P., & Lee, S. F. (2020). Nursing sensitive outcome indicators. Wfccn.Org.

Assessment 4 Instructions: Informatics and Nursing Sensitive Quality Indicators

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


As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality health care delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes. NURS-FPX4040 Assessment 4 Paper

The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.

NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.

The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove et al., 2018).

Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.

The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing- sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.

Reference – NURS-FPX4040 Assessment 4 Paper

Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.

Preparation for NURS-FPX4040 Assessment 4 Paper

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: NURS-FPX4040 Assessment 4 Paper

Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system. Choose from the following list:

Staffing measures.

Nursing hours per patient day. RN education/certification.

Skill mix.

Nurse turnover.

Nursing care hours in emergency departments, perioperative units, and perinatal units. Skill mix in emergency departments, perioperative units, and perinatal units.

Quality measures.

Patient falls.

Patient falls with injury. Pressure ulcer prevalence.

Health care-associated infections.

Catheter-associated urinary tract infection.

Central line catheter associated blood stream infection. Ventilator-associated pneumonia.

Ventilator- associated events.

Psychiatric physical/sexual assault rate. Restraint prevalence.

Pediatric peripheral intravenous infiltration rate.

Pediatric pain assessment, intervention, reassessment (air) cycle. Falls in ambulatory settings.

Pressure ulcer incidence rates from electronic health records. Hospital readmission rates.

RN satisfaction survey options. Job satisfaction scales.

Job satisfaction scales – short form.

Practice environment scale.

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? NURS-FPX4040 Assessment 4 Paper

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 Exemplar.

Recording Your Presentation – NURS-FPX4040 Assessment 4 Paper

To prepare to record the audio for your presentation, complete the following:

Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.

Practice using the equipment to ensure the audio quality is sufficient.

Review the for Kaltura to record your presentation.

View Creating a Presentation: A Guide to Writing and Speaking. This video addresses the primary areas involved in creating effective audiovisual presentations. You can return to this resource throughout the process of creating your presentation to view the tutorial appropriate for you at each stage.


You may use other tools to record your tutorial. You will, however, need to consult Using Kaltura for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.

You may also choose to create a video of your tutorial, but this is not required.

If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact to request accommodations.

NURS-FPX4040 Assessment 4 Paper Instructions

For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results. NURS-FPX4040 Assessment 4 Paper

The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data. NURS-FPX4040 Assessment 4 Paper

You determine that you will cover the following topics in your audio tutorial script:

Introduction: Nursing-Sensitive Quality Indicator

What is the National Database of Nursing-Sensitive Quality Indicators? What are nursing-sensitive quality indicators?

Which particular quality indicator did you select to address in your tutorial? Why is this quality indicator important to monitor?

Be sure to address the impact of this indicator on the quality of care and patient safety.

Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

Collection and Distribution of Quality Indicator Data

According to your interview and other resources, how does your organization collect data on this quality indicator? NURS-FPX4040 Assessment 4 Paper

How does the organization disseminate aggregate data?

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


As an example, consider the importance of accurately entering data regarding nursing interventions.


After completing your script, practice delivering your tutorial several times before recording it.


Additional Requirements for NURS-FPX4040 Assessment 4 Paper

Audio communication: Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

Length: 8–10 minute audio recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.

Script: A separate document with the script or speaker’s notes is required. Important: Submissions that do not include the script or speaker’s notes will be returned as a non-performance.

References: Cite a minimum of three scholarly and/or authoritative sources.

APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.

Competencies Measured in NURS-FPX4040 Assessment 4 Paper

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making. NURS-FPX4040 Assessment 4 Paper

Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance

patient safety, patient care outcomes, and organizational performance reports. Competency 3: Evaluate the impact of patient care technologies on desired outcomes.

Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient

safety, patient care outcomes, and organizational performance reports.

Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients. Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies. NURS-FPX4040 Assessment 4 Paper

Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

Follow APA style and formatting guidelines for citations and references.


Use the scoring guide to understand how your assessment will be evaluated.