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Nurses form the majority of the workforce in the healthcare profession. Therefore, effective nursing administration is important to ensure proper leadership and supervision of stakeholders for quality healthcare service delivery. These stakeholders include the nurses, clinicians, patients, educators, and nurse managers. Nurse administrators ensure that the healthcare services offered are safe, high quality, and geared toward improving the patients’ health. An assessment of the standard of healthcare provided in nursing is performed by evaluating quality indicators. The development of these quality indicators which are referred to as nursing-sensitive quality indicators aims at improving the nursing practice (Lorini et al., 2018).
Nursing-sensitive quality indicators are measures that reflect the level of the standard used to guide the assessment of the quality of nursing care. (Lorini et al., 2018). Nursing-sensitive quality indicators measure within structural, process, and outcomes aspects of nursing care (Lorini et al., 2018). The three aspects of nursing-sensitive quality indicators are important in maintaining a high-quality standard of nursing care, supporting proper management in the nursing profession, and evaluating the contribution of nurses to patient outcomes in an effort toward ensuring quality assurance.
The first category of nursing-sensitive quality indicators is concerned with the structural aspect of nursing. The nursing-sensitive quality indicators in the structural dimension of nursing are factors associated with the delivery of patient care by nurses (Lorini et al., 2018). In this dimension, the nursing-sensitive indicators are assessed through the availability of resources that are required in nursing care such as the personnel, physical, material, and financial resources. The level of education and certification of the nursing personnel, their skills, and the number of staff are used as structural quality indicators. As nurses are essential to the quality of health care that each patient receives, the personnel factor needs careful evaluation. For example, the patient-to-nurse ratio should be kept optimal to ensure that every patient receives the necessary care that they deserve.
Other structural quality indicators include the availability of physical and material resources such as clean toilets, waste disposal bins, clean running water, bandages, and hygiene guidelines. The availability and proper use of these physical and material resources are essential to reducing healthcare-acquired infections and improving the overall patient care outcome. Financial resources are required to offer efficient health care by ensuring that the required number of nurses is hired and physical and material resources are acquired.
The second category of nursing-sensitive quality indicators deals with the process aspect of nursing. The nursing-sensitive quality indicators associated with the process dimension of nursing are factors concerned with the direct care performed by nurses (Lorini et al., 2018). The process aspect of nursing involves evaluating the assessment of the patient and the interventions undertaken by the nurses. In the process dimension of nursing, the nursing-sensitive indicators are concerned with various aspects of patient care associated with their wellbeing, for example, the preparation of patients for surgery.
Proper preparation of patients for surgery should ensure that the consent form is filled and the surgical procedure and site are correctly identified. Other process indicators include the provision of physical restraints to the patients to avoid falls and, therefore, reduce risks of injuries. Patients should also be provided with proper nutrition and hydration and where necessary, they should be assisted with the intake of food through tube-feeding. Communication regarding the health status of a patient is an important process indicator. Effective communication should capture patient details such as their assessment at admission, the care performed in hospital wards, vital signs reading, and discharge instructions. Overall, process indicators provide an important stepping stone toward improving the quality of nursing care.
The third category of nursing-sensitive quality indicators focuses on the outcome aspect of nursing. The nursing-sensitive quality indicators in the outcome dimension of nursing are factors associated with the outcome of patient care provided by the nurses (Lorini et al., 2018). The outcome indicators are related to structure and process issues in nursing care because their quality determines the results of patient care. For instance, a patient falling and sustaining a fracture is an outcome indicator and depends on whether physical restrains were provided. In this case, the provision of physical restraints is a process indicator.
Weight loss is another patient outcome that is linked to nutrition, whose provision is a process indicator. Other outcome quality indicators include pain and its management, post-operative surgical wound infection, pressure ulcers, worsening locomotion, dehydration, and cognitive impairment among others. The assessment of patient satisfaction provides an efficient way to evaluate the quality of nursing care received. Patients’ satisfaction can be based on the overall nursing care received or some of its aspects. Additionally, the proportion of patients who died during the nursing care or the length of their stay in a hospital can be used as outcome quality indicators. Factors associated with a change in the health status of a patient can be used as outcome indicators.
In conclusion, the healthcare profession consists of various factors that affect the quality of the services offered to patients. The ultimate goal of the services offered to patients through nursing care is to restore their normal health status of patients. Nursing-sensitive quality indicators are, therefore, used to assess the quality of healthcare provided by nurses to patients and are categorized as structural, process, or outcome. These quality indicators are important in the development of the nursing profession as they enable the creation of evidence-based guidelines. Additionally, nursing-sensitive quality indicators ensure accountability and indicate areas of service provision that need to be improved. The nursing-sensitive quality indicators provide an excellent avenue for improving the quality of nursing practice.
Reference
Lorini, C., Porchia, B. R., Pieralli, F., & Bonaccorsi, G. (2018). Process, structural, and outcome quality indicators of nutritional care in nursing homes: A systematic review. BMC Health Services Research, 18(1), 43. Web.
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