Training Tutorial: Importance of Nursing Sensitive Quality Indicators


Primarily, the nursing practice aim at improving the safety and quality of care rendered to patients. From time to time, various approaches are called upon when the overall strategies are obsolete or are producing unwanted results. However, an organization cannot tell if it is doing well without evaluating its performance. Performance is measured based on certain nursing indicators that address specific areas of care provided. The American Nursing Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) were formed to collect and analyze data over time. Nursed are required to familiarize themselves with the indicators in various departments to provide quality care. Unfortunately, new nurses may have little or no knowledge about them, which calls for training tutorials. Senior officers, through training, should introduce the learners to new approaches to evaluating performance. The paper encompasses a training tutorial to expose new nurses to the necessity of nursing-sensitive quality indicators. It is based on independent research as a member of the Quality Improvement Council and an interview from a professional colleague.


As a Quality Improvement Council member, one is obliged to expose new nurses to nursing-sensitive quality indicators. I have been a member of the group in acute, ambulatory care for one year. The Council is interested in new nurses being introduced to collecting and disseminating information across the organization and their role in reporting high-quality results. The training tutorial is significant to new nursing practitioners in understanding the concept of nursing-sensitive quality indicators.

Training Tutorial

“My fellow nursing practitioners, I warmly and humbly welcome you to this program. Today, we will look at nursing-sensitive quality indicators in the department of acute, ambulatory care. At the end of the program, I believe each of you will understand what they are, how the data is collected and disseminated, and your roles in achieving improved results. Efforts to improve nursing practices are traced back to Florence Nightingale’s boosting the prevailing hospital conditions. Since then, numerous studies have been done, and the best approaches applied. Nursing-sensitive quality indicators refer to standardized and evidence-based practices that can be used with the available data to track and measure clinical performance and outcomes. As a result, we can identify potential quality improvement areas. Broadly, nursing-sensitive quality indicators are categorized into three, namely, structural, process, and outcome (Heslop et al., 2014). Structural indicators encompass the supply of nursing staff, their skills, certification, and their education levels. Process indicators entail evaluation approaches in patient assessment and nursing interventions. On the other hand, outcome indicators reflect patient results obtained from the applied mechanisms to improve care.

Meanwhile, nurses have a responsibility in informatics, which is a basis for collecting and disseminating information within a health care organization. Nursing practitioners in the contemporary world are blessed among generations by having modern technology at their disposal. One of the areas where technology is heavily invested in informatics (Darvish et al., 2014). Nurses in the acute, ambulatory sector work with an interdisciplinary team such as doctors and pharmacists. One of the roles of nurses and the multidisciplinary team is to improve documentation. Modern nursing care is hinged on individual patient needs and history. Electronic health information collected should encompass well-documented patient needs and history over time (Lowry et al., 2014). Well-documented and analyzed data over time will provide a clear distinction of the patient outcomes in that area that need improvements are pinpointed. Besides, nurses and the interdisciplinary team should boost their collaboration strategies. Despite the advent of modern technology in informatics, matters such as experience matters in data collection and dissemination. There are members with substantial data collection and management skills among the interdisciplinary team, which help new practitioners.

Patient care technologies have positively impacted the nursing services rendered in the unit entirely (Lowry et al., 2014). We live in a world cahracterized by new inventions and innovations in various aspects of medicine and nursing. One of the positive impacts accrued is minimized medical care. Minimized errors during medications are an indicator of improved care. Currently, modern technology has made it easier to collect data and disseminate it to respective departments in health care organizations (Darvish et al., 2014). Individual patient needs and history are analyzed and recorded for future use. With the expanded health informatics sector, medical errors in areas such as diagnosis are reduced. Apart from that, improved health informatics, courtesy of modern technology, has minimized costs. In our case, we can use the indicators to evaluate the performance, which promotes the aspect of reduced medical errors. As per the ANA, some of the hands of improvement in acute ambulatory care include; patient satisfaction with medication information provided, patient satisfaction with nursing care, and patient satisfaction with pain management. Errors lead to chaos and conflicts among the interdisciplinary team and increased costs to the organization and patients. Lastly, nursing-sensitive quality indicators reflect the multidisciplinary team’s effort such that when the results are not pleasing, coordination is called upon with immediate effect. Improved collaboration creates new robust approaches, which in turn boosts the performance of the organization.

The epitome of nursing-sensitive quality indicators in acute, ambulatory care over 20 years ago is associated with positive outcomes such as improved care and reduced costs. These aspects characterize the application of evidence-based practices (Burns & Grove, 2010). As stipulated by the NDNQI, we have three indicators, namely structural, process and outcome. These indicators deal with nursing capabilities, methods, and expected results, respectively, which denote quality improvement. The first step triggered by the hands was in 1999 when ANA identified ten implications of improved care in the acute, ambulatory department. They include patient satisfaction with pain management, nursing care, overall care, the medical information provided, pressure ulcers, patient falls, nurse job specifications, rates of nosocomial infections, total hours of nursing care per patient per day, and the staffing mix. The second step was to evaluate if the indicators were nurse-sensitive where they all qualified. With time other indicators are added, however, after being validated. ANA founded NDNQI to continue identifying indicators with evidence-based properties in nursing practice. Nursing-sensitive quality indicators conform to evidence-based practices in that they are evaluated before being applied (Burns & Grove, 2010). The signs are associated with improved outcomes such as reduced medical errors, which is a significant factor under evidence-based guidelines.”


Nursing-sensitive quality indicators are vital assessment tools as far improved care acute, ambulatory sector and other health systems are concerned. Since Nightingale’s efforts to improve care services a long time ago, the nursing practice has been revolutionized with evidence-based-practices. Through structures, processes, and outcomes, the indicators help collect, analyze, and disseminate data useful to boost the results. Nurses are obliged to keeping records well and coordinating health informatics. New nurses in the acute, ambulatory unit should be exposed to the indicators and evidence-based practices. The hands apply modern technologies which boost documentation and minimize medical errors. In turn, safety and quality outcomes are assured. Organizations should strive to use nursing-sensitive quality indicators for better results.









Burns, N., & Grove, S. K. (2010). Understanding nursing research-eBook: Building an evidence-based practice. Elsevier Health Sciences.

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science6(6), 11.

Heslop, L., Lu, S., & Xu, X. (2014). Nursing‐sensitive indicators: A concept analysis. Journal of advanced nursing70(11), 2469-2482.

Lowry, S. Z., Ramaiah, M., Patterson, E. S., Brick, D., Gurses, A. P., Ozok, A., … & Gibbons, M. C. (2014, June). Integrating electronic health records into the clinical workflow: an application of human factors modeling methods to ambulatory care. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 3, No. 1, pp. 170-177). Sage CA: Los Angeles, CA: SAGE Publications.

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