Last issue, we looked at measuring patient satisfaction through the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Join us this issue as we discuss using the National Database of Nursing Quality Indicators(R) (NDNQI(R)) to measure nursing's contribution to quality care and positive patient outcomes.
Q: Why's the NDNQI important?
A: The NDNQI is a voluntary database of unit-specific quality indicators that are directly related to nursing care. These data are important because they're reflective of the correlation between staffing ratios, direct patient care, and quality outcomes. Additionally, there are controls and processes for collecting and reporting the data that help ensure we're truly comparing apples to apples and not apples to oranges. You can compare your organization, unit, or service line to similar organizations or see how you benchmark against all organizations nationally.
The quality indicators are falls; falls with injury; pressure injuries (community-, hospital-, and unit-acquired); skill mix; nursing hours per patient day; RN surveys, including job satisfaction; restraint use; pain management; pediatric pain management; pediatric I.V. infiltrations; nursing turnover and vacancy rates; psychiatric patient assault rates; RN certification rates and education levels; and healthcare-associated infections, including ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections. Many of these indicators are part of the National Quality Forum's nursing care measure set-evidence-based standards that drive quality and excellence, and now affect reimbursement.
Within the database there are separate classifications: structure, process, and outcomes. This is useful because it assists with noting where an issue may be arising. For example, nursing turnover and nursing hours per patient day are structural and relate to staffing ratios and finance, whereas falls and infection rates relate to nursing policy, process, compliance, and outcomes.
The American Nurses Association (ANA) established the NDNQI in 1998 to meet the need to evaluate nursing's impact on healthcare, along with what effect workload, workflow, and nurse-patient ratios have on patient outcomes. The ANA determined that data collection should be ongoing as part of the profession's responsibility to monitor itself and promote quality outcomes.
The University of Kansas Medical Center School of Nursing manages the database under contract with the ANA. The University assists organizational site coordinators to label and classify each unit, and arranges educational tutorials on data tools, collection, and reporting so that the process is understood and followed as required for participation.
The NDNQI is essential for evaluating processes and outcomes, and driving evidence-based practice. It remains a critical tool in the nursing professional toolkit to ensure accountability, transparency, and quality improvement.
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