NURS-FPX4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

Informatics and Nursing Sensitive Quality Indicators Nursing Informatics

Hey everyone and Welcome to Shane’s Hospital! A level-1 trauma center! We are happy to have you as part of our team, and I look forward to guiding you on this new journey. The med-surg team is already aware of your recent hire and excited to teach, and learn with you! The focus is on informatics and nursing sensitive quality indicators, focusing on pressure ulcers. So, let’s dive right in! Nursing quality indicators fall under three different categories: structural indicators, process indicators, and outcome indicators.

NURS-FPX4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

There is more than one sensitive quality indicator, and feel free to review the others at your own availability. Today, we will be focusing on pressure ulcers. According to Stalpers, (2016), nursing care quality is important, because it is linked to patient safety, patient satisfaction, and other health care outcomes. You likely wouldn’t be here if you did not love helping others and improving their healthcare quality outcome.

NURS-FPX4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators

What is the NDNQI?

What is the NDNQI, I get it why is he throwing a bunch of letters at us so quickly. The NDNQI stands for the national database of nursing quality indicators. According to Boyle, (2016), the NDNQI will collect data on hospital acquired pressure ulcers in order to provide standardized rate calculators across patient care units and hospitals – allowing for easy comparisons of like units in like hospitals for quality improvement initiatives.

Hospital-acquired pressure ulcers are widely recognized, and are important measures of inpatient nursing care quality as stated by (Boyle et al, 2016). What does this have to do with your job function? You aren’t going to let any pressure ulcers happen on your watch! According to Limin, (2021), The level of nurse staffing is the most important factor influencing patient outcomes, and a pooled analysis showed a higher level of nurse staffing decreased the risk of inpatient mortality by 14%. I am guessing by now you already realize how the important role you play in helping prevent pressure ulcers in patients, and how valuable you are in preventing harm in your patients.

Interdisciplinary Approaches in Quality Indicators.

Are you already overwhelmed? Are you thinking this pressure ulcer management is a lot for once nurse to manage? Don’t worry! The interdisciplinary team plays a role also, so you are not alone! According to Clarkson, (2019), An integrated team-based approach towards pressure ulcer prevention has long been promoted as best practice. Achieving an interprofessional team approach requires professional groups to have knowledge of the causative factors associated with pressure ulcers and strong attitudes towards prevention. This is not all from outside resources, I even have some information from another nurse you will soon be working with!

(Kath) stated its more than just the nurse, we have wound nurses, rescue nurses, physical therapists, occupational therapists, nurse practitioners, physicians, charge nurses, and patient care technicians that all help in preventing pressure ulcers. In this hospital its clear the team is large, and everyone has their own role in preventing pressure ulcers. Each part of the interdisciplinary team has its own role, and their own assessments in ensuring the correct data is collected at a rate to reduce and improve pressure ulcers. According to Clarkson, (2019), interprofessional approach that utilizes knowledge from across the healthcare team help provide effective pressure ulcer prevention.

Evidence based practice guidelines

Alright everyone! What are we going to do in order to prevent pressure ulcers? How are do we even collect the data? What does Shane’s hospital do with this information after its collected? Great questions! According to Beal, (2016), there is still much work to do. Maine General Medical Center has implemented a number of interventions to continue on the improvement trajectory, such as focusing on education and buy – in of new hires and reminders for longer term staff, encouraging the culture and actions that sustain an attitude of 0% hospital acquired pressure ulcers maintaining those interventions that have proven to be effective in the hospital, while disposing of ineffective action, and reviewing the overall program annually.

I am sure you can see how important you are to us and helping prevent pressure ulcer injuries already! Nurses are the ones who spend the most time with patients, and have the largest role in helping prevent pressure ulcers. Nurses pass the medications, answer call lights, assess patients’ multiple times throughout their shift, and are the first to help the patient and family understand how they can also play their role in preventing pressure ulcers.

I wanted to bring you a better insight into our specific hospital, and of course I have more information provided form one of your new nurse colleagues! (Kath, 2021) stated the big thing to remember is to not feel bad about reporting a pressure injury. She said it may or may not even be caused by you, and although its something we want to prevent, we can only improve if we have accurate data and documentation of all pressure ulcers acquired. The nursing staff has two meetings (huddles) a day before each shift.

During these huddles you will learn about which patients have the criteria for possible pressure ulcers, and patients who already acquired them. (If any). This hospital collects its data by the staff reporting them. It typically starts with letting the charge nurse know, who then documents in the electronic file, and paper file. It then moves on to the department manager, who then sends it to the next department that reports these pressure ulcers. The report goes to the entire staff at the hospital in the monthly meetings, and to key stakeholders. So, who gets it to continue progress for prevention of pressure ulcers across the nation? If you said NDNQI, you are really paying attention and on track to be great! I wish you the best of luck and look forward to meeting you all in person!

NURS-FPX4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators References

Beal, M. E., & Smith, K. (2016). Inpatient Pressure Ulcer Prevalence in an Acute Care Hospital Using Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(2), 112– 117.

Boyle, D. K., Jayawardhana, A., Burman, M. E., Dunton, N. E., Staggs, V. S., Bergquist- Beringer, S., & Gajewski, B. J. (2016). A pressure ulcer and fall rate quality composite index for acute care units: A measure development study. International journal of nursing studies, 63, 73–81.

Clarkson, P., Worsley, P. R., Schoonhoven, L., & Bader, D. L. (2019). An interprofessional approach to pressure ulcer prevention: a knowledge and attitudes evaluation. Journal of multidisciplinary healthcare, 12, 377–386.

Kath, M. (2021, September, 2021). personal.

Limin, W Hongbo, C , Qiaoqin, W, Ting, C, Xu, D, Xiuxiu, H, Han, L., Shaomei, S. (2021). Effects of self‐rated workload and nurse staffing on work engagement among nurses: A cross‐sectional survey, Journal of Nursing Management.

Stalpers, D., Kieft, R., van der Linden, D., Kaljouw, M. J., & Schuurmans, M. J. (2016). Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators. BMC health services research, 16, 120.

NURS-FPX4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators Sample Solution 2

Hello, everyone. Welcome to this engagement session; my name is (enter your name here). This training session’s primary aim is to familiarize you with nursing-sensitive quality indicators, the National Database of Nursing Quality Indicators (NDNQI) role, and nurses’ role in supporting accurate reporting and high-quality results. I hope you will understand all these concepts by the end of this session.

What is the National Database of Nursing Quality Indicators (NDNQI)?

The National Database of Nursing Quality Indicators (NDNQI) is an American database that provides quarterly and annual reports about nursing quality indicators alongside conducting systematic data collection or nursing indicators for performance measurements at the national level. Also, the NDNQI compares the performance of more than 1100 US health organizations at the unit level. Finally, this national database provides operative measures to address various indicators, including pressure ulcers, falls, staff mix measures, job satisfaction, selective nosocomial infection, and human resource management issues.

What are nursing-sensitive indicators?

Barchielli et al. (2022) define nursing-sensitive quality indicators (NSI) as “those indicators that capture care or its outcomes most affected by nursing care” (p. 2). In this sense, they focus on nursing processes, outcomes, and structures consistent with Donabedian’s classification. Nursing-sensitive quality indicators include the prevalence of pressure ulcers, patient falls, nursing education level and skills, hospital structure and setting, nurse-to-patient ratios, and pain management approaches. Also, NSI encompasses human resource management aspects like job satisfaction, turnover, and burnout.

The selected quality indicator

Pressure ulcer prevalence is one of the quality measures that prompt healthcare professionals to implement evidence-based and patient-centered care. According to Ebi et al. (2019), pressure ulcers are preventable medical complications associated with immobility and lengthy hospitalization. The risk factors for pressure ulcers are incontinence, inadequate nutrition and hydration, advanced age, immobility, and device-related skin pressure. Getie et al. (2020) contend that pressure ulcers are preventable if healthcare professionals apply appropriate Measures, including enhancing patients’ mobility, monitoring and modifying the environment, shifting the patient’s weight frequently, ensuring sufficient nutrition and hydration, and improving patients’ comfort and dignity.

Why it is essential to monitor this quality indicator.

Frequent monitoring of pressure ulcer prevalence is essential in informing prevention interventions and improving outcomes. According to Getie et al. (2020), pressure ulcers occur due to the shortage of supplies for pressure ulcers, time pressure, insufficient knowledge of evidence-based preventive measures, and job dissatisfaction. As a result, tracking the hospital’s performance on this quality indicator is essential to identify the root causes, establish performance benchmarks and targets, and develop evidence-based approaches for preventing pressure ulcers and their effects, including deaths, prolonged hospitalization, and increased care costs.

Why do new nurses need to familiarize themselves with this quality indicator when providing care?

As you transition from nursing students to healthcare professionals, you will encounter a high prevalence of pressure ulcers and their subsequent ramifications. Our organization has established measures to prevent pressure ulcers. A contingency plan entails hourly rounds, enhancing patients’ mobility, modifying the environment to address risk factors, educating patients on effective strategies for reporting incidences of pressure ulcers, and using bedside technologies to alert clinicians to patients’ discomfort. As new nurses, you must familiarize yourself with these interventions, understand your roles, and work in teams to address this problem. By familiarizing yourself with this quality indicator, you will assist the organization in implementing and sustaining intervention plans for change and quality improvement.

Organizational Strategies for Collecting and Distributing Quality Indicator Data

Strategies for disseminating aggregate data in our organization

During an interview with our organization’s chief nursing informaticist, he revealed that our organization has various strategies for collecting and disseminating data. One of these strategies includes using an electronic health record system (EHRS) to store, share, and retrieve information regarding nursing care processes and interventions to improve quality indicators. Secondly, nurses are responsible for utilizing patient health records and collecting first-hand qualitative and quantitative data from patients.

Data from patients entail response to care processes, self-reported incidences of pressure ulcers, diagnoses, and response to medications. After collecting data and recording it on the electronic health record system, nurse informaticists facilitate its visualization by integrating it into hospital dashboards. Helminski et al. (2022) contend that hospital dashboards analyze and present information regarding performance metrics, allowing clinicians to visualize actionable data and optimize organizational performance.

Besides using hospital dashboards to visualize and disseminate data, the hospital relies massively upon clinical reports, journal publications, posters, pamphlets, and guidelines as primary approaches for disseminating information on quality improvement indicators and interventions for enhancing care quality. However, the Chief Nursing Informaticist unearthed various challenges that compromise the culture of effective data collection and dissemination. These challenges include time pressure, increased workload, burnout, and functionality issues of the electronic health record system (EHRS).

The role of nurses in supporting accurate reporting and high-quality results

Nurses understand the intricacies and demands of the current healthcare systems by developing meaningful relationships with patients and providing direct care. These close relationships involve gathering patient information and leveraging informatics to improve care quality and outcomes. According to Kennedy et al. (2017), nurses are responsible for using information regarding a patient’s history and current condition through physical assessments and laboratory tests. To support data accuracy, high-quality results, and effective reporting, nurses should understand the functionality of the electronic health record system, take adequate time to record and report information and enhance communication with patients to obtain reliable and credible data.


As you join our team, remember that you have an ethical and professional obligation to benefit patients, prevent harm, uphold their values and preferences, and ensure justice in care delivery. As a result, I am convinced that everyone understands the role of the National Database of Nursing Sensitive Quality Indicators, nursing sensitive indicators, and the role of nurses in supporting accurate reporting and high-quality results. As we move forward, I endeavor to assist you in understanding quality improvement indicators that form the basis of organizational processes, outcomes, and structures. Thank you very much for your time.

NURS-FPX4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators References

Barchielli, C., Rafferty, A. M., & Vainieri, M. (2022). Integrating key nursing measures into a comprehensive healthcare performance management system: A Tuscan experience. International Journal of Environmental Research and Public Health, 19(3), 1–14.

Ebi, W. E., Hirko, G. F., & Mijena, D. A. (2019). Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: A cross-sectional study design. BMC Nursing, 18(1).

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.

Helminski, D., Kurlander, J. E., Renji, A. D., Sussman, J. B., Pfeiffer, P. N., Conte, M. L., Gadabu, O. J., Kokaly, A. N., Goldberg, R., Ranusch, A., Damschroder, L. J., & Landis-Lewis, Z. (2022). Dashboards in health care settings: Protocol for a scoping review. JMIR Research Protocols, 11(3), e34894.

Kennedy, B., Dietrich, M., Mion, L., Novak, L., & Jeffery, A. (2017). A qualitative exploration of nurses’ information-gathering behaviors prior to decision support tool design. Applied Clinical Informatics, 08(03), 763–778.

Informatics and Nursing-Sensitive Quality Indicators audio script Example 3

Hello. I welcome you to my audio presentation on nursing and quality. My name is    and I am a nurse at   . In this audio presentation, I will describe nursing-sensitive quality indicators and the National Database of Nursing-Sensitive Quality Indicators. I will also describe the process of collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports in our healthcare organization. You will get to understand your role in the process and why an interdisciplinary team’s input is also vital to the success of this process. Lastly, you will understand how our healthcare organization uses nursing-sensitive quality indicators.

Introduction to National Database of Nursing-Sensitive Quality Indicators

Before I describe the National Database of Nursing-Sensitive Quality Indicators, I will introduce you to what Nursing-Sensitive Quality Indicators are. A recent journal article by Afaneh et al. in 2021 defined nursing-sensitive quality indicators and reviewed recent literature on the concept of NSQIs and their implications in current practice. Nursing-Sensitive Quality Indicators, also known as NSQIs, are a set of performance measures and outcomes that are directly or indirectly affected by nursing and thus reflect the impact of nursing care on the patients’ health. It is possible to use these indicators to establish a common ground for benchmarking and to provide evidence of the cost-effectiveness of nursing care in order to establish a benchmarking plan.

In 1988, the American Nurses Association set up a database that collected, analyzed and reported specific indicators. This database was called The National Database of Nursing Quality Indicators TM (NDNQI®). This database is headquartered at the University of Kansas Medical Center (KUMC) School of Nursing. The purpose of this database was to improve patient safety and care quality through scientific and evidence-based decision-making. Since then, there has been an increase in the use of NSQIs in healthcare as a means of measuring the impact of nursing care on patient outcomes. 

In addition, it helps to identify best practices across different healthcare facilities by allowing for comparison of nursing care. Nursing leadership can also use NSQIs as a tool for allocating resources, making decisions and making decisions that improve the quality of care based on this information. These indicators include various staff measures and quality measures. NSQIs are used to evaluate the quality of nursing care and to identify areas for improvement. For this audio presentation, I selected pressure ulcer incidence rates as the NSQI.

Pressure ulcers are localized areas of damage to the skin caused by unrelieved pressure on an area of the body. Pressure ulcer incidence rates represent the new number of cases of patients with pressure ulcers, also known as bedsores, in some care settings. Knowing the new number of cases of bedsores is crucial because it reflects the quality of nursing care that patients receive in our healthcare organization.

According to the Agency for Health Care Research and Quality website, the United States has more than 2.5 million pressure ulcers each year. These skin lesions cause pain, infection, and increased healthcare use. Therefore, this indicator is vital in improving the quality and safety of the nursing care that patients receive in the hospital. New nurses need to be familiar with this particular quality indicator when providing patient care. This is important because every admitted patient is at risk of developing pressure sores and ulcers when under your care, and it is your ethical and professional responsibility to protect your patients from preventable harm.

Collection and Distribution of Quality Indicator Data

Data on NSQIs is collected using a variety of methods, such as electronic medical records, patient surveys, and direct observation of the patient. This data is analyzed, and the results are used to identify improvements to be made, as well as to track the progress of the patient over time. I had an interview with the nurse informaticist, who is our institution’s NDNQI site coordinator. The site coordinator periodically consolidates and reports the NSQI data to the NDNQI databases and disseminates this feedback to the hospital and various institutions.

Therefore, nurse leaders and hospital administrators can use this data to make administrative decisions and policies, while direct clinical care providers can improve their care standards using these reports. Data on the incidence rates of pressure ulcers are collected through our electronic health record system, which detects entry of pressure ulcers from nurses, doctors, and other healthcare providers in the hospital, such as physician assistants. Therefore, it is important to enter accurate data when building health histories for patients.

Nurses play an important role in documenting patient data during the collection and reporting of quality health indicators. Your participation in quality improvement begins with documentation of the new cases of pressure ulcers in the patient’s electronic medical record. To improve patient safety and quality regarding this particular indicator, it would be helpful to have accurate reporting to implement evidence-based quality improvement initiatives. 

This also calls for interdisciplinary team input because the prevention of pressure sores requires multidisciplinary approaches. Nurses will need to collaborate with doctors and other healthcare providers to implement and evaluate various strategies based on the latest evidence to improve patients’ health. According to Sullivan et al. (2023), a number of nursing specialties and general nursing practices are represented by established NSIs.

Overall, the pressure ulcer incidence rate is just of the many indicators that nurses need to participate in reporting and evaluating to provide safe care. As your patient’s advocate, it is your ethical call to ensure they get safe care. Therefore, a good nurse will participate in assessing, evaluating, and applying nursing-sensitive quality indicators. Thank you for listening. Until next time, Goodbye!


Afaneh, T., Abu-Moghli, F., & Ahmad, M. (2021). Nursing-sensitive indicators: a concept analysis. Nursing Management (Harrow, London, England: 1994), 28(3), 28–33.

Agency for Health Care Research and Quality. (n.d.). Preventing Pressure Ulcers in Hospitals. Retrieved January 29, 2023, from

Sullivan, C. E., Day, S. W., Ivankova, N., Markaki, A., Patrician, P. A., & Landier, W. (2023). Establishing nursing-sensitive quality indicators for pediatric oncology: An international mixed methods Delphi study. Journal of Nursing Scholarship, 55(1), 388–400.

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