Nursing Quality Indicators Explained

NURSING QUALITY INDICATORS
By
Deepak Kumar Sen
Nursing educator
Metro hospital & cancer research center (M.P.)

QUALITY INDICATORS
 Quality indicators are the means to judge the real
performance of certain clinical as well as
managerial parameters selected for monitoring
and evaluation.
 The Quality Indicators (QIs) are measures of
health care quality that make use of readily
available hospital inpatient administrative data.

SUMMARY OF STANDARDS
 NQI.1There is a structured quality
improvement and continuous monitoring
program for nursing service.
 NQI.2 The organization identifies key
indicators to monitor the structures, processes
and outcomes, which are used as tools for
continual improvement for nursing services.
Contd….

SUMMARY OF STANDARDS
CONTD….
 NQI.3 The nursing quality improvement
program is supported by the management
 NQI.4 There is an established system for
nursing audit
 NQI.5 Incidents, complaints and feedback
from nursing professionals are collected and
analysed to ensure continual quality
improvement.

NQI.1
STRUCTURED QUALITY IMPROVEMENT AND
CONTINUOUS MONITORING PROGRAMME

NQI.1
Objective elements Interpretation Remarks
The quality
improvement
programme is
developed,
implemented and
maintained by a
committee with a
representative from
nursing personnel
There is need for a
formal controlled
documentation. This
will be aligned with
the organizations
quality improvement
program
At minimum, a
“nursing manual”
shall be established.
Contd….

NQI.1
There is a designated
individual for
coordinating and
implementing the
nursing quality
improvement
programme
Self explanatory This individual shall
necessarily be a
senior and
experienced nursing
professional
preferably with
exposure to NABH
and quality
standards
Contd….

NQI.1
The quality
improvement
programme shall be
reviewed at periodic
intervals.
Self explanatory It should be
reviewed and
updated at least once
every year.

NQI 2
IDENTIFICATION OF KEY INDICATORS

NQI 2
The patient falls are
monitored and the
incident of patient falls is
documented by the
appropriate nursing
professionals.
The factors responsible
for patient fall can be
classified as under
1) Nursing related
2) Patient related
unbalanced or
unsteady gait,
incorrect use of
equipment.
3) Falls requiring
medical intervention.
Self explanatory
Contd….

NQI 2
The hospital
acquired
decubitus/pressure
ulcers in various
departments are
monitored and
recorded as per laid
down protocols by
the HCO
Self explanatory Self explanatory
Contd….

NQI 2
The medication
errors during
provisioning of care
are monitored and
recorded on
occurrence by the
concerned nursing
staff in forms as laid
down by the HCO
Contd….

NQI 2
Monitoring of
accidental delining
( If applicable)

NQI 2
All extravasations
are recorded and
monitored as per
the laid down
protocols.
Contd….

NQI 2
All needle stick
injuries are
documented and
monitored as per the
policy laid down by
the HCO that should
be in consonance
with the national
and international
guidelines.
Contd…..

NQI 2
All restraint related
incidents are
monitored and
documented
Contd…..

NQI 2
The hand hygiene
compliance is
monitored and
recorded by the
nursing professional
responsible for the
same.
Self explanatory.
The monitoring
should be as per the
criteria identified by
the WHO guidelines
on hand hygiene.
Self explanatory
Contd…

PAIN ASSESSMENT AND MANAGEMENT

NQI 2
The compliance
with pain
assessment and
management is
monitored by the
senior nursing
professional while
undertaking their
professional rounds
and the same is
documented.
Contd…

NQI 2
The satisfaction of
patients with the
nursing care is
monitored by the
senior nursing
professionals and the
same is documented.

QUALITY IMPROVEMENT PROGRAMME.

NQI 3
NURSING QUALITY IMPROVEMENT PROGRAMME
The management
makes available
adequate resources
required for quality
improvement
programme.
This shall include
the men, material,
machine, money and
method. These
should be in steady
supply so as to
ensure that the
programme
functions smoothly
Contd…

STATISTICAL AND MANAGEMENT
TOOLS

NQI 3
The management
supports and
implements use of
appropriate quality
improvement,
statistical and
management tools in
its quality
improvement
programme.
Self explanatory For example, Root
Cause Analysis,
FMEA, Project
Evaluation and
Review Technique
(PERT), Critical
Path Method(CPM)
control charts, etc.
Contd….

NQI 3
The senior nursing
professionals as
delineated by the
HCO also monitor
the nursing
satisfaction based on
pre determined
criteria in
consultation with
human resource
department of the
HCO
Contd….

NQI 3
The attrition rate
and frequency of
attrition of the
nursing professional
is monitored and
documented by the
head of the nursing
in consultation with
the human resource
department of the
HCO

NQI 5
ESTABLISHED SYSTEM FOR NURSING AUDIT
Nursing staff
participates in the
audit
The organization
shall identify such
personnel. It shall
necessarily include
senior and junior
nursing
professionals and
could be a mix and
clinicians and
administrators.
These could be
members of the core
committee/ nursing
quality assurance
committee, etc.
Contd….

NQI 4
The parameters to be audited
are defined by the organization
As these audits are
retrospective/ concurrent in
nature. It is imperative that
this be done using predefined
parameters so that there is no
bias. The parameters could be
disease based, nursing protocol
based, nursing documentation
based, cost based, community
based or based on morbidity
( length of stay)
It shall lay down the objectives,
the parameters that are going
to be captured, develop a
checklist where required,
sampling and data collection
guidelines and preparation of
report.
The audit shall encompass all
aspects of care including
clinical and nursing
Contd…..

NQI 4
Patient and staff
anonymity is
maintained.
This means that the
names of the patients
and the hospital staff
who may figure in
the audit documents
must not be
disclosed or any
reference be made to
them in public
discussion/
conferences.
This is at the stage of
report preparation
and dissemination.
The staff
participating in the
audit shall maintain
patient and staff
anonymity and not
reveal names.
Contd…..

NQI 4
All audits are
recorded and
reviewed
Self explanatory The organization
could use a checklist
with the predefined
parameters and the
audit findings could
be recorded on this
sheet.
Contd….

NQI 4
Implementation is
recorded and
reviewed.
All remedial
measures as
ascertained should
be documented and
implemente4d and
improvements
thereof recorded to
complete the audit
cycle.
This should
preferably be done
based on root cause
analysis.
Contd….

NQI 5
COLLECTION & ANALYSIS OF INCIDENTS,
COMPLAINTS AND FEEDBACK
The organization has
an incident reporting
system
The incident
reporting system
includes :-
a) Identification
b) Reporting
c) Review
d) Action on
incidents.
These could be
members of the core
committee/ nursing
quality assurance
committee, etc.
Contd….

NQI 5

NQI 5
Corrective and
preventive action are
taken based on the
findings of such
analysis.
The objective of this
is to continually
improve the quality
of patient-care
services.
All such action shall
be documented.
Contd….

NQI 5
a process to collect
feedback and receive
complaints
Self explanatory This shall be
communicated to the
patients using
displays or
brochures.
Contd….

NQI 5
established processes
for analysis of
incidents, feedbacks
and complaints.
The quality
improvement
committee shall be
responsible for this
activity
This could
preferably be done
by identifying the
root cause where
possible; it is
preferable that
patients be included
in analyzing the
feedback and
complaint.
Contd….

NQI 5
Feedback about care
and service is
communicated to
staff.
At a minimum,
patient satisfaction
levels shall be
communicated on a
monthly basis.
This could be done
using internal
communication. It is
equally important
that positive
feedback about care
and services is
communicated to
staff.
Contd….

CONCLUSION
 System for monitoring and measurement of
nursing quality standards shall be established
 Statistical review and analysis of trends shall
be reviewed by the organization.
 These act as tools for excellence in nursing
care delivery and satisfaction with nursing
care amongst patients.
 Contributes to overall improvement in quality
of care

Nursing Quality Indicators Explained

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Nursing Quality Indicators Explained

Similar to Nursing Quality Indicators Explained (20)

Recently uploaded

Recently uploaded (20)

Nursing Quality Indicators Explained