Nursing Quality Improvement

Over the past year and a half the Nursing Quality Program at Children’s National has taken a very active role in highlighting quality processes. The goal of the program is to promote quality and safety improvement through various activities. The program addresses nurse-sensitive quality indicators by participating in national nursing databases such as NDNQI (National Database of Quality Indicators) and NACHRI (National Association of Children’s Hospitals and Related Institutions) and conducts evidence-based performance improvement activities at the unit and department level.

The Nursing Quality Indicator (NQI) program is an integral component of the Nursing Services at Children’s National Health System and is in alignment with the organizational strategic quality plan.  Part of the NQI involves the monitoring of Nursing Sensitive Indicators (NSIs).

Currently, all NSIs were developed based on a literature review. Starting in 2012, the Clinical Improvement and Nursing Research Council (CINRC) will be asking nurses responsible for NSI development to incorporate an evidence table into each NSI development plan. These evidence tables will be a great resource for nurses who have questions about why a particular NSI is necessary or about the degree to which the interventions designed to improve the care indicator are evidence-based.

Culture of Nursing Excellence (CONE) teams:

Nurse involvement in quality improvement includes establishing processes for data collection, data analysis and display and data dissemination.  Nurses must examine their quality improvement data on a regular and close to real time basis in order for improvements to be maintained and sustained. The concept of the CONE team was established as a collaborative and shared structural adjunct between the Department of Nursing Research and Quality Outcomes and the clinical areas.  The CONE team provides a structure to analyze processes and to improve clinical outcomes by addressing unit-specific care improvements in three nurse sensitive indicator categories:  clinical outcomes, patient satisfaction and RN satisfaction.  This triadic approach between the nurse leader, nurse educator, and clinical nurses in the clinical areas is the driver of quality improvement for their unit.