Nursing-Sensitive Indicators (NSIs)
Nursing-sensitive indicators (NSIs) are measures and indicators reflecting the structure, process (es) and outcomes of nursing care. These measures help to reflect the impact of care that nurses in healthcare facility provide.
Efforts to classify the quality of nursing practice began a long time ago when the pioneer of modern nursing Florence Nightingale when she was working to improve the hospital conditions and measure the patient outcome. She was a notable statistician who used statistical methods to generate reports that correlate patient outcome to the environmental conditions as well as practices.
Gathering data to identify and examine nursing outcomes on healthcare system or patient care is now the term nursing-sensitive indicators or nurse-sensitive outcomes. In recent times, research linking nurse staffing matters and adverse patient outcomes have got the attention of the people within and out health care.
Much of the researching on a correlation between the two began in the 1990s and early 2000s. It was during an era when the situation about nursing shortage was bleak. Nursing reported burnout, understaffing and job dissatisfaction. Reports that understaffing was causing an increase in mortality got the interest of the media and public in studies of NSIs. It is this attention that helped to create a way of measuring other indicators relating to the quality of patient care.
A team of researchers came up with the phrase “nursing-sensitive indicators”reflecting the elements of patient care that directly affect nursing practice. It has now become a buzzword in modern health care.
Types of Nursing-Sensitive Indicators
These nursing-sensitive indicators reflect the essential aspects of nursing care.
1. Structural indicators: indicators that combine supply of nursing staff, their education, certification and skill levels.
2. Process indicators: Measures methods of patient examination and the subsequent nursing interventions. Nursing job satisfaction is also a process indicator.
3. Process indicators: NSIs that reflect patient outcomes that are accepted to be nursing-sensitive as they depend on the quality and quantity of nursing care. Process indicators include things like falls and ulcers.
There are other types of patient outcomes relating to other elements in medical care but health care profession does not regard them to be nursing-sensitive. These not NSIs outcomes include things like cardiac failure and readmission rates.
Nursing-sensitive indicators are specific to nursing are different from medical indicators of patient care quality. They are the outcomes with an influence of nursing care. They have gone through a long history and evolutionary strides in research and measurement s, but there is still much more to learn.
Benefits of Nursing-Sensitive Indicators
Nursing-sensitive indicators help facilities to determine a link between the care that a facility provides and patient outcome. The show a deficit is particular areas of nursing care assisting the facilities to justify the need for increasing nursing staff. NSIs also help to prove improvements in patient care after increasing nursing staff once the additional nurses start to work. Another benefit of nursing indicators is that they help healthcare faculties to effectively use their additional staff by identifying the areas where they can be more useful. Enhancements to Nursing-Sensitive Indicators American Nursing Association (ANA) expanded these indicators to enable the hospitals to gain a better understanding of the patient care they offer. They began with these initial measurements in 2002, but they are subject to refining.
Patient satisfaction with:
These symptoms are indicators that the patient is likely to have a small bowel obstruction.
- Pain management
- Nursing care
- Medical information provides
- Overall care
- Patient falls
- Pressure ulcers
- Hospital-acquired infections
- Job satisfaction of nurses
- Hours of nursing care per day, per patient
- Staffing mix (the ratios of licensed practicing nurses, registered nurses and other unlicensed staff)
These symptoms are indicators that the patient is likely to have a small bowel obstruction.
Other measurements are:
After identifying this first group of indicators, ANA became sort of pioneers in the evidence-based practice. It made an effort to conduct a literature search for identifying other signs that had the potential to be nurse sensitive. After a thorough review, ANA validated the signs that were indeed nursing-sensitive and discarded those that did not meet the criterion.
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