Evaluating Patient Falls Using Nursing-Sensitive Quality Indicators

This report provides an analysis of nursing-sensitive quality indicators (NSQI), with a specific focus on patient falls. It highlights the importance of NSQIs in evaluating and improving the quality of nursing care, referencing the National Database of Nursing-Sensitive Quality Indicators (NDNQI) and its role in collecting and analyzing unit-level data. The report discusses patient falls as a critical indicator, detailing the risks, consequences, and risk factors associated with falls in healthcare settings. It also explores the methods of data collection and distribution related to patient falls within a healthcare organization, emphasizing the responsibilities of nurses in preventing falls, ensuring accurate reporting, and promoting positive patient outcomes. The significance of accurate nursing documentation for effective clinical communication and high-quality care is also underscored, citing relevant research and studies to support the analysis.

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Nursing-Sensitive Quality Indicators
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Nursing-Sensitive Quality Indicators
Introduction
The field of nursing is complicated and includes several aspects. Nursing-sensitive
quality indicators (NSQI) were developed to evaluate the quality of nursing care. Improved care
outcomes can be achieved, and quality enhancement initiatives like education campaigns and
community outreach can be launched with the aid of nursing-sensitive quality indicators that
serve as evidence-based practice recommendations in the inpatient and outpatient settings. The
NSQI assesses the efficiency of care by concentrating on particular aspects. Different types of
NSQI exist, such as those that measure structure, process, and results. The public is routinely
given in-depth analyses of structural factors, including nurse staffing, nursing skill levels, and
certification status. Outcome markers like falls and ulcers are also heavily studied. Few people
pay attention to process indicators like nursing interventions and nurse satisfaction. This tutorial
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The National Database of Nursing-Sensitive Quality Indicators (NDNQI) is a repository
developed as part of a safety and quality effort in the nursing profession. Since shifts in the labor
force made it clear that evaluating connections between nurses and the quality of patient care
was crucial, the National Database of Nursing-Sensitive Quality Indicators was developed based
on the results of pilot studies testing nursing-sensitive indicators. The National Database of
Nursing-Sensitive Quality Indicators is the only national database that regularly reports unit-
level nursing care architecture, outcome indicators, and evaluation methods (Lake et al., 2020, p.
2160). The NDNQI's primary mission is to collect and analyze unit-level data from participating
hospitals for use in quality improvement efforts, and its secondary mission is to collect and
analyze national data on the correlations between nurses and patient outcomes. As a result,

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hospitals in every state voluntarily join NDNQI and share patient data to further the
organization's goals. Teaching hospitals, community hospitals, children's hospitals, and adult
hospitals are all represented in the NDNQI initiative.
Nursing-sensitive indicators are patient outcomes relevant to the nurse's area and domain
of practice and are determined by nursing interventions or inputs. Nursing-sensitive indicators
are the health status and outcome changes that may be attributed directly to nursing care (Yang et
al., 2019, p. 49). Also, nursing-sensitive indicators establish a foundation for tracking and
gauging the efficacy of nursing services. Establishing a common basis for nursing care standards
can help enhance patient outcomes. Yet, several indicators can be particularly sensitive to
changes in nursing care, such as the number of falls, the number of nursing care hours per
patient, and the prevalence of pressure ulcers. Therefore, all nursing-sensitive variables should
be considered equally essential because they determine whether nursing care substantially
influences patients.
Patient falls with injury are the nursing-sensitive indicator of choice for this tutorial.
Since patient falls seriously threaten patient safety, it is important to address this indicator.
Furthermore, patient falls are a major cause of morbidity and mortality in medical facilities and
hospitals. According to recent studies, roughly thirty percent of patient falls result in harm
(DiGerolamo & Chen-Lim, 2021, p. 48). Hence, patient falls and their consequences must be
handled and prevented. Patients who fall have a higher risk of having a longer hospitalization,
experiencing worse health outcomes, and using more hospital resources. It's important to note
that fractures and soft tissue injuries sustained in falls can cause serious pain, emotional distress,
and functional impairment for those who experience them. Moreover, several patient fall risk
factors must be addressed. For instance, DiGerolamo & Chen-Lim, (2021, p. 46) indicated that

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functional impairment, prior falls, and lower extremity deficits are crucial risk factors for patient
falls.
As a result, nurses of all experience levels should be aware of the nursing significance of
the quality indicator of patient falls. Therefore, new nurses should pay special attention to this
nursing-sensitive signal to get acquainted with their duties in preventing patient falls. As a result,
novice nurses can gain valuable experience with fall-prevention measures and interventions. A
recent study on patient falls DiGerolamo & Chen-Lim, (2021, p. 47) found a good correlation
between nurses' knowledge of patient falls and their attitudes and behaviors aimed at preventing
them. For this reason, newly licensed nurses must be aware of their responsibilities in reducing
the likelihood of patient falls. Also, nurses are responsible for educating patients on fall
prevention measures.
Collection and Distribution of Quality Indicator Data
Patient falls resulting in injury and those that do not result to injuries are recorded in a
data collection spreadsheet in the organization, according to the interview. In particular, as
patient falls occur, data is regularly added to the spreadsheets. Nonetheless, the data is compiled
from interviews and observations of patients and caregivers present during the accident. Patients
and caregivers who were there at the time of the fall can provide valuable insight into what led to
the incident and what injuries resulted. In addition, a medical examination is performed to
determine the extent of the fall's effects before the spreadsheet is filled out. Then we manually
scan the documents and enter the data into our electronic records system. Errors are minimized,
and data sharing is facilitated due to this system's organization and storage methods. Electronic
health records simplify getting, sharing, and analyzing patient information (Adler-Milstein et al.,

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2020, p. 533). Although, other healthcare organizations have developed specialized data
collection sheets to record, quantify, and analyze information about patient falls.
The organization takes several routes to share aggregate data on nursing-sensitive
indicators like patient falls. For instance, the company informs its employees about patient falls
that have occurred at the institution. The company prints brochures and distributes them to every
unit in the building. The staff also has regular team meetings to distribute information and
promote in-depth conversations about patient falls and best practice solutions. Moreover,
according to Chapman et al. (2020, p. 2), actively disseminating healthcare knowledge is more
efficient because it requires more energy to reach patients and other healthcare personnel.
Meanwhile, the group uses local media to educate the public on the severity of issues like patient
falls and preventative measures that hospital visitors can take.
Even though patient falls are frequently reported as a nursing-sensitive quality indicator,
nurses have a variety of responsibilities in avoiding falls, ensuring correct reporting of falls, and
fostering positive patient outcomes. For instance, nurses should do fall risk analysis and
screening for their clients and make the results available to other medical staff. In addition,
nurses are responsible for documenting individualized plans to reduce the risk of falls. Patient-
specific fall prevention techniques recorded in a medical record have improved accuracy and
reduced fall risks (Leland et al., 2022, p. 2192). However, if a patient falls, the nurse must notify
a doctor to document the fall and make an injury assessment.
Moreover, nurses must ensure patients can access equipment like walkers and canes.
Also, nurses should monitor nurse aides to avoid neglectful falls. Nurses that do their jobs
properly boost reporting accuracy, provide better treatment, and see better results for their
patients. To deliver high-quality, risk-free treatment, nurses must record their interventions

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accurately. For instance, nurses may not always be able to recall the specific therapies or best
practices they utilized in the past with a given patient. Errors cannot be avoided without detailed,
accurate patient records. Accurate nursing documentations are crucial for efficient clinical
communication (Asmirajanti et al., 2019, p. 2). They also accurately reflect nursing assessments,
care given, and patient information to ensure safe and high-quality care is provided.

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References
Adler-Milstein, J., Zhao, W., Willard-Grace, R., Knox, M., & Grumbach, K. (2020). Electronic
health records and burnout: time spent on the electronic health record after hours and
message volume associated with exhaustion but not with cynicism among primary care
clinicians. Journal of the American Medical Informatics Association, 27(4), 531-538.
Asmirajanti, M., Hamid, A. Y. S., Hariyati, R., & Sri, T. (2019). Nursing care activities based on
documentation. BMC nursing, 18(1), 1-5.
Chapman, E., Haby, M. M., Toma, T. S., de Bortoli, M. C., Illanes, E., Oliveros, M. J., &
Barreto, J. O. M. (2020). Knowledge translation strategies for dissemination with a focus
on healthcare recipients: an overview of systematic reviews. Implementation Science,
15(1). https://doi.org/10.1186/s13012-020-0974-3, 1-14.
DiGerolamo, K. A., & Chen-Lim, M. L. (2021). An educational intervention to improve staff
collaboration and enhance knowledge of fall risk factors and prevention guidelines.
Journal of pediatric nursing, 57, 43-49.
Lake, E. T., Riman, K. A., & Sloane, D. M. (2020). Improved work environments and staffing
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Leland, N. E., Lekovitch, C., Martínez, J., Rouch, S., Harding, P., & Wong, C. (2022).
Optimizing post-acute care patient safety: a scoping review of multifactorial fall
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Yang, S. U., Huang, L. H., Zhao, X. H., Xing, M. Y., Shao, L. W., Zhang, M. Y., ... & Gao, C.
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