The American Nurses Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI) in the late 1990s to outline the quality of nursing care and increase the nursing body of knowledge related to quality (Montalvo, 2007). Nursing tenets steer nurses to assess, calculate and enhance practice. Quality indicators help improve nursing practice by benchmarking data, trends, reports and education. Two particularly important quality indicators are the outcome measure of restraint prevalence and the process/outcome measure of patient falls. The national database works to track data regarding these issues for nursing to improve outcomes in these areas.
Two nursing sensitive indicators of significant importance is restraint prevalence and patient falls. The National Quality Form (NQF) establishes “…consensus standards for nursing-sensitive care, including evidence-based nursing-sensitive performance measures, a framework for measuring nursing-sensitive care, and related research recommendations” (National Quality Forum, 2020). Falls are especially problematic for hospitals and the nursing practice because they increase length of stay for patients, increase cost and decrease revenue related to falls because a hospital acquired condition (HAQ). Similarly, restraint prevalence is identified as a NDNQI by the NDF due to negative outcomes associated with use. Although restraints are utilized to help keep patients safe through restricting removal of lifesaving tubes and lines, the negative outcomes associated include agitation, emotional trauma, nerve and vascular injuries, bedsores, and loss of dignity (Kirk et al., 2015; Lagambi et al., 2021; Thomann et al., 2021).
Restraint Reduction, Restraint Elimination, and Best Practice by Kirk et al., outlines the associated issues with restraint utilization that cause the NQF to establish it as a NDNQI. The authors outlined a unit specific program to decrease restraint utilization below the NDNQI mean for restraint utilization. This unit specific program utilized advanced practice nurses coupled with multidisciplinary rounding to utilize less-restraining options such as elbow boards and soft mitts in lieu of soft restraints (Kirk et al., 2015). Similarly, treating underlying medical conditions causative of agitation decreased restraint utilization. Resultant of the restraint reduction, as suggested by NDNQI, the unit was able to bring the rate of restraint utilization to 1.67% less than the NDNQI mean on the surgical step-down unit and 7.12% on the surgical intensive care unit within the first year (Kirk et al., 2015).
The second text examined, Reliability and Validity of the NDNQI Injury Falls Measure, works to authenticate the NDNQI guideline related to falls. The NDNQI collects unit-specific, nurse sensitive data from nearly 2,000 hospitals who benefit from reporting by using data to improve quality outcomes (Garrard et al., 2016). The authors utilized a survey of injury fall measure from NDNQI partner hospitals to validate the results manifested from the NDNQI measures. The measures were found to show robust evidence “…that the NDNQI falls with injury measure is reliable and valid in supporting hospitals’ fall prevention efforts and future injurious falls research” (Garrard et al., 2016). That is, the NDNQI injury falls measure is a consistent and legitimate means for non NDNQI hospitals and outside scholars to endorse potential quality improvement endeavors and falls investigation.
The salient points of nursing research based on NDNQI outline that data driven quality indicators evidence a need for nursing related change to increase quality care and decrease negative outcomes. Kirk et al., presents data related to measures to decrease restraint utilization as suggested by NDNQI. Likewise, Garrard et al., notes validation of NDNQI data through assessment of data from NDNQI partner hospitals. It is through continual assessment of data and utilization of NDNQI that nursing can improve patient outcomes and satisfaction with care.
References
Garrard, L., Boyle, D. K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal of Nursing Research, 38(1), 111–128. https://doi-org.ezp.waldenulibrary.org/10.1177/0193945914542851
Montalvo, I. (2007). The national database of nursing quality indicators. OJIN: The Online Journal of Issues in Nursing, 12(3). Retrieved from Order A Similar Paper
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