Charting the course for American Nurses Credentialing Center–Approved perioperative nurse-sensitive indicators

Abstract

The current health care environment, with increasing public awareness of and attention to patient safety, mandates the delivery of exceptional quality care. To meet the health care requisites of the perioperative patient population, clinical nurses have identified the need for nurse-sensitive clinical indicators for this setting. We describe the strategies used to identify, obtain American Nurses Credentialing Center approval for, and integrate nurse-sensitive indicators into the perioperative setting to advance a Magnet culture. Prior to this, nurse-sensitive indicators for the perioperative setting that enabled nurses to monitor and improve patient care outcomes, in accordance with the standards of a Magnet-recognized hospital, had not been formally established. A review of the literature yielded a list of potential metrics, which included normothermia, patient falls with harm, and retained surgical items. Methodology and data collection processes for these metrics were established, facilitating quarterly Nursing Dashboards and collaboration among nurses to improve patient outcomes. This groundbreaking initiative enables nurses to routinely evaluate whether the structures and processes of care effectively yield quality outcomes. This foundational work has broader implications for nursing practice, because these quality metrics can easily be translated into perioperative settings in other health care organizations.

Improving 9.5 Million Lives: Pilot Testing Ambulatory Care Nurse-Sensitive Quality Indicators

“…Themes identified in our study, nursing role ambiguity and value of and barriers to ACNSIs, mirrored what is currently known about indicators in general across inpatient and outpatient settings. Specifically, strong information technology (IT) support, training, understanding the purpose and use of NSIs, adequate time, leadership support, and staff engagement are critical to implementing and sustaining NSIs 21-24 . Lack of leadership and staff engagement are due in part to limited understanding of the specific roles and contributions of ambulatory care nurses to quality outcomes.…”

“…Specifically, strong information technology (IT) support, training, understanding the purpose and use of NSIs, adequate time, leadership support, and staff engagement are critical to implementing and sustaining NSIs. [21][22][23][24] Lack of leadership and staff engagement are due in part to limited understanding of the specific roles and contributions of ambulatory care nurses to quality outcomes. Leadership perceptions demonstrated a lack of knowledge regarding nurses' roles in ambulatory care.…”