Arming Frontline Nurses With Data to Improve Outcomes

Purpose:
Frontline nurses are key to improving quality and safety of patient care. They provide critical interventions that determine outcomes. Our institution is committed to developing the “quality literacy levels” of our staff, enabling them to understand and apply quality metrics.

Significance:
While frontline nurses are skilled in providing patient care, they are often less skillful in using data to evaluate nursing practice and effect change.

Strategy and Implementation:
To effect change, we have developed integrated interventions to assist leadership and empower frontline nurses 1) develop knowledge of quality and safety processes; 2) apply these processes to patient outcome issues relevant to their practice; 3) develop innovative strategies to improve outcomes and 4) analyze the processes and the outcomes using methods to identify successes and need for improvement in quality and safety. Each unit receives a monthly “quality scorecard” that details unit-based nurse-sensitive data related to quality, patient experience, and operations. These data are reviewed by frontline leadership and staff who participate in a Nursing Quality shared governance council where outliers are discussed and strategies identified. Frontline staff assist in the development of action plans that are contextualized to their practice area.

Evaluation:
Significant improvement in hospital acquired pressure ulcers illustrates progress made following application of this model. Frontline staff were able to identify the effects of variation and modify interventions. HAPU rates declined from 7.2 to 1.1 since implementation of this process.

Implications for Practice:
Assisting frontline nurses develop "quality literacy levels" has been an effective strategy in improving patient outcomes. The data are customized to units, allowing staff to develop and implement measures appropriate to the needs of the patients.