The National Database of Nursing Quality Indicators (NDNQI) is a nursing portfolio that provides reports on the process, structure, and outcome metrics that explore the care at a unit level. Usually, the reports are derived at quarterly or yearly intervals. Nursing-sensitive indicators refer to the elements of patient care that may be influenced by the nursing practice in most healthcare settings today. The nursing indicators usually reflect on structural, process, and outcome indicators from a clinical perspective. The American Nurses Association (ANA) identified various critical nursing-sensitive indicators in acute care setup. Some of the elements that were listed by ANA include patient satisfaction with pain management, pressure ulcers, nurses’ job satisfaction, and nurse turnovers, among others. This paper presents an assessment of nursing-sensitive indicators by focusing on nursing turnover.
Why it is Important to Monitor Nursing Turnover
Nurse turnover refers to the issue of nurses leaving their place of work to pursue other ventures that may or may not be related to their specialization. Therefore, the decision for a nurse to stop working for a given healthcare organization for any given reason can be highly linked with an indicator that there is a deficit in care quality or environment of work. It is essential to monitor nurse turnover because it affects the quality of care and also the financial perspective (Lim, 2021). When nurses are managed effectively, high-quality care is achieved hence, setting the right standards for an organization delivering clinical duties.
When researching the experts through the interviews as proposed by the assessment requirements, various issues were noted. First, the current rate of nurse turnover globally ranges from 8.8% to 36.5% (Lim, 2021). There is variation depending on the region and also the nursing specialty. In the US, for instance, the average is almost 18% for registered nurses (RN), whereby it has been difficult to keep staffing ratios with the events of nursing turnover. RNs are among the top occupations when it comes to job growth, and it is expected that by 2025, the number of registered nurses shall increase by 15% (Lim, 2021). Therefore, there must be close monitoring of staff turnover in a healthcare setting.
The other reason why it is important to monitor nursing turnover is the financial impact it has. The average cost of these turnovers in an organization ranges between $37,500 to $58,500, with other costs within the aspect. Therefore, if an organization incurs costs due to the turnover rate, it may not be able to deliver clinical duties up to the required levels. Reducing the turnover rate for nurses may help grow the field by focusing on the developmental and other initiatives that will improve the quality of care in these organizations. It is important to note that the cost of replacing a nurse may be high, up to $82,000 (Rios-Zertuche et al., 2018). That is inclusive of induction and any other form of training that the personnel will go through to understand the culture of the organization.
Patient safety is also affected by nursing turnover as leaving a gap means it will not be possible to have critical management of a patient’s condition since doctors may lack enough nurses who will collaborate in ensuring that patients are taken care of when they are admitted. There is always a reason why nurses want to leave, and thus, the issue may be disturbing them while working (Lim, 2021). Therefore, it may lead to an ineffective way of managing sensitive ailments when it comes to patient nursing. The trend of having to replace workers makes it hard for hospitals and other healthcare firms to have a disrupted way of coordinating work within the organization. When there are gaps in transactions, it may be difficult to have established formations that lead to patient safety.
Nurses should understand that turnover is allowed, but it has major impacts. When a person working in a critical department such as an intensive care unit (ICU) leaves work, it may be a challenge to replace the member with a person who understands all the metrics relating to ICU from an experience level (Lim, 2021). Additionally, RNs must understand that having to venture into other engagements may contradict their code of ethics, whereby breaching the agreements and terms will be a likelihood. Thus, nurses must be sensitive not to go while leaving behind a disorganized place of work that may be harmful to patient safety. Always, the affected group should have a way to address internal issues with the nursing leadership to ensure the turnover rate is low. Therefore, the above factions, as mentioned above, it makes a logical opinion as to why nurse turnover should be monitored.
Collection and Distribution of Quality Indicator Data
The organization collects data on nurse turnover through a checklist that establishes the number of nurses who are hired and the duration they take when working on the roles given. In this matter, the organization develops a structure that information about the turnover is filled and also other elements such as cost for training after nurses have left. Another way o how the organization collects data is through surveys (Bergren, 2016). In this case, the quality care department indulges in research by benchmarking the established hospitals on their way of working and managing nurses. The other notable way of collecting data on the sensitive indicator has been through the filling of questionnaires whereby nurses feed data anonymously about instances where they had to leave the organization at one point in their career. The data collected is analyzed, and the team is determined to reduce the challenges that may make nurses yield to turnover desires.
The organization disseminates aggregate data through publishing program and policy briefs, sharing information that is necessary through the organization’s website, and discussing issues related to the data through programs that are aired in mainstream media. The key audiences for this part include nurses and their managing groups that must work together towards ensuring the effective delivery of healthcare services (Bergren, 2016). For example, the firm recently developed a framework that shows all that pertains to nurse turnover and uploaded it on the website. The information and data help the working staff to see the impact of nursing turnover. When people are aware of a possible impact regarding a given action, they will be sensitive to do it hence, ensuring there is a linear flow of information.
The nurses have a key role to play when it comes to accurate reporting and high-quality results. For example, there could be interventions such as decreasing the weekly overtime that may make the nurses have a negative feeling while working. In this case, RNs must implement preceptor and mentor programs that help new working staff during their first years of working (Bergren, 2016). The other role nurses have to play is to perfect the working environment through addressing major diverse issues that may limit teamwork, personal determination, and other progressive aspects. Therefore, nursing-sensitive indicators relate to issues such as staff turnover that must be addressed to cut costs incurred and also improve patient safety.
Bergren, M. (2016). The feasibility of collecting school nurse data. The Journal of School Nursing, 32(5), 337-346. Web.
Lim, J. (2021). Characteristics of elderly care work that influence care workers’ turnover intentions. Healthcare, 9(3), 259. Web.
Rios-Zertuche, D., Zúñiga-Brenes, P., Palmisano, E., Hernández, B., Schaefer, A., & Johanns, C. et al. (2018). Methods to measure quality of care and quality indicators through health facility surveys in low- and middle-income countries. International Journal for Quality in Health Care, 31(3), 183-190. Web.