1.      Discuss the use of NDNQI goals in evaluating nursing performance 

2.      Share strategies for integrating the NDNQI data into nursing performance appraisals to promote achievement of NDNQI goals

Nursing performance appraisals provide a mechanism to encourage professional growth and career advancement.   The National Database of Nursing Quality Indicators (NDNQI) can be  integrated into the performance appraisal process in order to promote achievement of NDNQI goals.       

Purpose: This session will review processes used to integrate NDNQI goals into nursing performance appraisal evaluations to target improvements in NDNQI data at a Midwestern Magnet designated facility.

 Overview: A shared governance model provides the central organizing structure for nursing and includes the development of Division of Nursing and unit based quality and professional goals. Performance appraisals are conducted by nurse managers who oversee one or several clinical specialty areas.  Each unit develops performance improvement and quality goals and integrates assessment of goal achievement through different mechanisms.  A novel approach to ensuring awareness of the importance of NDNQI was implemented on a medical surgical nursing unit through integrating NDNQI goals into the nursing performance appraisal process.   

Several strategies for integrating NDNQI data goals in performance appraisals have proven successful including creating specific goals targeting NDNQI indicators as an expectation for all staff.  As an example, one of the medical surgical nursing goals was focused on reducing the prevalence of hospital acquired patient skin breakdown.  The overriding goal was to achieve wound prevalence that was at or below the mean of the NDNQI.  Nursing staff performance evaluation criteria were developed to reflect the goals and included increasing levels of responsibility based on a clinical ladder system.  All nurses were required to demonstrate accurate and thorough skin assessment and documentation on admission, compliance with Braden scale documentation, and compliance with approved methods of wound care.  Based on clinical ladder levels, additional responsibilities included demonstrating competence in wound interventions, participating in unit based quarterly audits, and serving as a unit clinical expert/resource in skin assessment and documentation.  As a result of integrating NDNQI goals into the nursing performance appraisal process, significant results were achieved on the percent of patients with hospital acquired pressure ulcers.  This was attributed in part to the performance appraisal process which integrated NDNQI goals. 

 Implications for Practice:  Promoting the use the NDNQI in clinical practice by integrating assessment of performances targeting NDNQI goals has proved to be a successful strategy. This session will highlight processes used and strategies for sustaining integration of the NDNQI into nursing performance appraisals that will be useful for participants in designing projects tailored to their settings.