Creating and Analyzing a Statewide Nursing Quality Measurement Database

Aydin, Carolyn E.; Bolton, Linda Burnes; Donaldson, Nancy; Brown, Diane Storer; Buffum, Martha; Elashoff, Janet D.; Sandhu, Meenu

doi:10.1111/j.1547-5069.2004.04066.x

Cited by 58 publications

(54 citation statements)

References 12 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pressure ulcer prevention rests squarely in the domain of nursing care. There is a professional organization of nurses with extensive training in skin care, an array of prevention technologies, standardized surveillance definitions, an established methodology for determining prevalence, and large benchmarking projects, including the American Nurses Association National Database of Nursing Quality Indicators, implemented in the early 1990s [21], and the California Nursing Outcomes Coalition, beginning in 1996 [22,23]. Thus, pressure ulcer prevention might be characterized as at least T3 to T4 at the time of the HAC policy roll out.…”

Section: Discussionmentioning

confidence: 99%

Chief nursing officers’ perspectives on Medicare’s hospital-acquired conditions non-payment policy: implications for policy design and implementation

et al. 2012

View full text Add to dashboard Cite

BackgroundPreventable adverse events from hospital care are a common patient safety problem, often resulting in medical complications and additional costs. In 2008, Center for Medicare and Medicaid Services (CMS) implemented a policy, mandated by the Deficit Reduction Act of 2005, targeting a list of these ‘reasonably’ preventable hospital-acquired conditions (HACs) for reduced reimbursement. Extensive debate ensued about the potential adverse effects of the policy, but there was little discussion of its impact on hospitals’ quality improvement (QI) activities. This study’s goals were to understand organizational responses to the HAC policy, including internal and external influences that moderated the success or failure of QI efforts.MethodsWe employed a qualitative descriptive design. Representatives from 14 Nurses Improving Care of Health System Elders (NICHE) hospitals participated in semi-structured interviews addressing the impact of the HAC policy generally, and for two indicator conditions: central-line associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). Within-case analysis identified the key components of each institution’s response to the policy; across-case analysis identified themes. Exemplar cases were used to explicate findings.ResultsInterviewees reported that the HAC policy is one of many internal and external factors motivating hospitals to address HACs. They agreed the policy focused attention on prevention of HACs that had previously received fewer dedicated resources. The impact of the policy on prevention activities, barriers, and facilitators was condition-specific. CLABSI efforts were in place prior to the policy, whereas CAUTI efforts were less mature. Nearly all respondents noted that pressure ulcer detection and documentation became a larger focus stemming from the policy change. A major challenge was the determination of which conditions were ‘hospital-acquired.’ One opportunity arising from the policy has been the focus on nursing leadership in patient safety efforts.ConclusionsWhile the CMS’s HAC policy was just one of many factors influencing QI efforts, it may have served the important role of drawing attention and resources to the targeted conditions—particularly those not previously in the spotlight. The translational research paradigm is helpful in the interpretation of the findings, illustrating how the policy can advance prevention efforts for HACs at earlier phases of research translation as well as pitfalls associated with earlier phase implementation. To maximize their impact, such policies should consider condition-specific contextual factors influencing policy uptake and provide condition-specific implementation support.

show abstract

Section: Discussionmentioning

confidence: 99%

Chief nursing officers’ perspectives on Medicare’s hospital-acquired conditions non-payment policy: implications for policy design and implementation

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Data were transferred to a CALNOC automated Microsoft Excel spreadsheet and submitted to the data repository for these hospitals to benchmark their ongoing comparative performance. Additional details of the CALNOC procedures were described by Aydin et al 20,21 CALNOC maintains institutional review board (IRB) approval at both Cedars-Sinai Medical Center and the University of California San Francisco for ongoing data analyses related to benchmarking performance and research. Prevalence studies are performed for quality assurance purposes rather than research, so IRB approval at each individual hospital was not needed.…”

Section: Methodsmentioning

confidence: 99%

Eliminating Hospital-Acquired Pressure Ulcers

Stotts

Brown

Donaldson

et al. 2013

Advances in Skin &Amp; Wound Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…The mean duration of hospitalization and the occupancy rate can be considered as traditional indicators in relation to the production and the productivity of the health services and were used as overall performance indicators by the majority of hospitals in a previous study (2) , being included in the questionnaire applied to the nurses in the present study. However, less than 50% of the nurses systems (12)(13) and the NAGEH group (4) .…”

Section: Discussionmentioning

confidence: 99%

“…The use of indicators of mortality, nosocomial infection rates, device use, unforeseen readmissions and others specifically related to the nursing processes, such as the incidence of falls, incidence of pressure ulcers, number of patients restrained in bed, patient satisfaction and hours of training were considered essential for evaluating the quality of the healthcare provided to the client (1,(12)(13) . Several authors stress that the knowledge, monitoring and analysis of these indicators should serve as a basis for the improvement of the nursing processes in the hospital institutions, since they constitute critical points of the processes related to the nursing care (3)(4) .…”

Section: Discussionmentioning

confidence: 99%

Use of performance indicators in the nursing service of a public hospital

Gabriel

Melo

Rocha

et al. 2011

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

The study aimed to identify performance indicators adopted by the Nursing Service of a public hospital and to analyze the opinions of the nurses regarding the use of these indicators to evaluate the quality of the nursing care. This is descriptive exploratory study with a quantitative approach, which used data from the management reports of the institution and applied a questionnaire in a sample of 25 nurses. It was found that the institution works with three databases of indicators, two being general and one specific for Nursing, which analyze 11 indicators. The indicators of pressure ulcer incidence and incidence of falls were the only ones considered highly relevant to qualify the nursing care for 100% of the nurses. It was concluded that the institution uses indicators for monitoring outcomes and tends to valorize the use of process indicators by the nurses to evaluate the Nursing performance, with it being necessary to expand the analysis to include multi-disciplinary indicators. Trata-se de estudo descritivo exploratório, com abordagem quantitativa, que utilizou dados dos relatórios gerenciais da instituição e aplicou questionário numa amostra de 25 enfermeiros. Verificou-se que a instituição trabalha com três bancos de dados de indicadores, sendo dois gerais e um específico de enfermagem que analisa 11 indicadores.Os indicadores de incidência de úlcera por pressão e incidência de quedas foram os únicos considerados muito pertinentes para qualificar a assistência de enfermagem, por 100% dos enfermeiros. Concluiu-se que a instituição utiliza indicadores para acompanhamento de resultados e há valorização da utilização de indicadores de processos pelos enfermeiros para avaliar desempenho da enfermagem, sendo necessário ampliar a análise para indicadores multidisciplinares.Descritores: Indicadores de Serviços; Serviço Hospitalar de Enfermagem; Qualidade da Assistência à Saúde. Utilización de indicadores de desempeño en servicio de enfermería de hospital públicoEl estudio objetivó identificar indicadores de desempeño adoptados por el Servicio de Enfermería de hospital público y analizar la opinión de los enfermeros en relación a la utilización de estos indicadores para evaluar la calidad de la asistencia de enfermería. Se trata de estudio descriptivo exploratorio con abordaje cuantitativo, que utilizó datos de los informes de gestión de la institución y aplicó un cuestionario en una muestra de 25 enfermeros. Se verificó que la institución trabaja con tres bancos de datos de indicadores, siendo dos generales y uno específico de enfermería que analiza 11 indicadores. Los indicadores de incidencia de úlcera por presión y de caídas fueron los únicos considerados muy pertinentes para calificar la asistencia de enfermería por 100% de los enfermeros.Se concluye que la institución utiliza indicadores para acompañamiento de resultados y existe una valorización de la utilización de indicadores de procesos por los enfermeros para evaluar desempeño de la enfermería, siendo necesario ampliar el análisis para indicadores mul...

show abstract

Creating and Analyzing a Statewide Nursing Quality Measurement Database

Cited by 58 publications

References 12 publications

Chief nursing officers’ perspectives on Medicare’s hospital-acquired conditions non-payment policy: implications for policy design and implementation

Chief nursing officers’ perspectives on Medicare’s hospital-acquired conditions non-payment policy: implications for policy design and implementation

Eliminating Hospital-Acquired Pressure Ulcers

Use of performance indicators in the nursing service of a public hospital

Contact Info

Product

Resources

About