Maika`i: Excellence in Nursing Care, Measuring, Monitoring and Evaluating NDNQI Data at the Unit Level

Purpose:
In pursuit of Magnet designation, The Queen's Medical Center's nursing body identified the need to strengthen the bedside nurse's knowledge and ownership of the nurse sensitive indicators measured and reported to NDNQI. The goal and mantra was, “drive data down to the unit level.”

Significance:
The nurses at the bedside make the impact on nurse sensitive indicators. For the nurses to own the data and have an impact on the clinical outcomes they need to understand what the data is telling them. Nurses need to understand how the data is captured, how to interpret and how to analyze it.

Strategy and Implementation:
Two years before the Magnet application was sent to ANCC for review, nurses throughout the medical center were at different levels of understanding and engagement regarding NDNQI data, even though the medical center had been participating with NDNQI since 2000. Various strategies were implemented throughout the nursing organization to “drive the data down to the unit level.” The goal: all nurses will be able to speak to their unit's data. Multiple strategies have been implemented to educate, disseminate, facilitate and engage the nurses in understanding and owning their unit specific and hospital wide NDNQI data. High visibility with alignment of annual organizational goals with nurse sensitive indicator goals is key. A Patient Care Scorecard with monthly updated data is utilized as a unit specific talking tool. Performance improvement projects with data presented at monthly nursing grand rounds, as well as national conferences by staff nurses are a few strategies implemented.

Evaluation:
Magnet designation was achieved in April 2009. One of the comments in the closing summary and executive session was " Your nurses on all the units could speak to their data. How did you engage the staff so to take such ownership"?

Implications for Practice:
You are a reflection of what you measure and in turn pay attention to. Nurses want the best for their patients. Capturing nurse sensitive data has multiple implications for practice. Through performance improvement methodologies with solid data to measure and monitor, care will be improved.