Question

Describe the 6 nursing sensitive indicators in NDNQI (Falls, restraints, VAP, CLABSI, CAUTI, HAPU), identify & explain 2 nursing actions for each indicator that can prevent these occurrences. Must have citations and references-see instructions. English (United States MacBook Air F4 ES F6

Answer 1

NDNQI- Nursing-sensitive indicators reflect the structure, process, and patient outcomes of nursing care.

Structure - supply of nursing staff, skill level of staff, and education of staff

Process - assessment, intervention, and job satisfaction

Outcomes - patient outcomes that improve if there is greater quantity and quality of nursing care.

The National Database of Nursing Quality IndicatorsTM (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level.

VAP- Ventilator-associated pneumonia (VAP) is pneumonia that develops 48 hours or longer after mechanical ventilation is given by means of an endotracheal tube or tracheostomy. Ventilator-associated pneumonia (VAP) results from the invasion of the lower respiratory tract and lung parenchyma by microorganisms. There are following nursing action:

1 Minimize ventilator exposure

The most important evidence-based practice for lowering VAP risk is minimizing a patient’s exposure to mechanical ventilation, which can be achieved in two ways.

First, encourage and advocate for the use of noninvasive ventilation approaches, such as bilevel positive airway pressure or continuous positive airway pressure. The face masks used with these approaches can be uncomfortable for patients, but data from a small randomized clinical trial suggests that similar benefits can be achieved using a helmet instead. In addition to better patient comfort, helmets resulted in a significantly lower intubation rate compared to face masks.

2 Provide excellent oral hygiene care

Oral health quickly deteriorates in mechanically ventilated patients. Some patients sustain injuries to the oral mucosa during the intubation procedure, and after intubation, patients are prone to dry mouth. These factors, in addition to a severely compromised immune system, can cause an increase in bacteria colonization in the oral mucosa, with the endotracheal tube serving as a direct route to the lungs.

CLABSI-A central line-associated bloodstream infection (CLABSI) is defined as a laboratory-confirmed bloodstream infection not related to an infection at another site that develops within 48 hours of a central line placement.

Nurses are making an impact in reducing central line-associated bloodstream infections (CLABSI). Reducing CLABSI rates improves quality and safety of patient care and favorably impacts the financial stability of the healthcare organization.

CAUTI-A catheter-associated urinary tract infection (CAUTI) is one of the most common infections a person can contract in the hospital, according to the American Association of Critical-Care Nurses. Indwelling catheters are the cause of this infection. An indwelling catheter is a tube inserted into your urethra.

The presence of an indwelling urinary catheter (IUC) is the principal risk factor for catheter-associated urinary tract infection (CAUTI) development. As the providers most involved with IUCs in hospitalized patients, nurses are responsible for IUC placement, day-to-day catheter management, and the removal of IUCs.

HAPU:This measure defines the number of patients who developed a new pressure ulcer after admission to the hospital. Lower numbers are better. A score of zero (0) is best because it means there were no HAPUs.