Working Smarter -- Innovative National Database of Nursing Quality Indicators (NDNQIŽ) Prevalence Survey Data Collection

Purpose:
To devise a strategy to streamline data collection for NDNQIŽ prevalence surveys. By leveraging the electronic medical record, the use of resources were minimized with improved reliability and validity of data used to improve practice and reduce adverse outcomes.

Significance:
Prevalence surveys provide data for three nursing sensitive indicators that are used to measure the quality of nursing practice. A significant amount of clinical nurses' time is required to obtain valid and reliable data but can be reduced through automation of chart review.

Strategy and Implementation:
A small group collaborated to design, program, and manage a data collection tool used for prevalence surveys over the last 12 months. NDNQIŽ data collection guidelines specify data that may be collected by medical records review. Extracting data elements from a data warehouse and pre-populating the database prior to the actual survey reduces the amount of time clinical nurses are unavailable for patient care. In addition, data to make decisions about the appropriateness of interventions are available on the data entry screens. Clinical nurses are required to complete training and a cognitive test before they are given access to the data collection tool. Once the survey is completed, a nurse analyst reviews the data for errors or discrepancies and makes corrections as appropriate. In addition to the data collection tool, a report was developed to assist with correctly identifying hospital acquired pressure ulcers and where the patient was when an ulcer developed.

Evaluation:
Quarterly prevalence surveys in the past required two clinical staff for eight hours per unit. After implementation the time required was reduced to three hours or less. Since implementation the organization has experienced a significant and sustained decline in hospital acquired pressure ulcers.

Implications for Practice:
Automation of data collection reduces the impact on resources and allows for almost immediate feedback to clinical units on their performance. In addition to collecting data required by NDNQIŽ, compliance with policy and best practices can be monitored and used to guide future improvement.