Understanding the NDNQI: Overview and FAQ
Better patient outcomes are most safely achieved through data-driven, measurable, quality improvements. The National Database of Nursing Quality Indicators (NDNQI) serves as an important tool for evaluating the effectiveness of nurse-led quality initiatives within a healthcare facility (or unit). It works by tracking key nursing quality indicators (such as patient falls) and providing the framework for assessing how nursing care influences patient safety and outcomes.
Familiarizing yourself with this database for nursing-sensitive quality indicators (QIs) can help you leverage the voluntary program to optimize your practice standards and management strategies. In this article, we’ll establish the framework’s fundamentals and answer common questions around its use. With the information you need to effectively apply nursing QIs in systemic processes, you’ll be better equipped to drive high quality patient care while ensuring staff and organizational well-being.
The National Database of Nursing Quality Indicators: Overview
Originally developed in 1998 by the American Nurses Association (ANA), the database for nursing-specific quality indicators quickly became a healthcare gold standard for collecting, analyzing, and sharing QI data. Then, after more than a decade heading the NDNQI, ANA officials sold the program to Press Ganey, which has remained its managing company since the 2014 acquisition.
Currently, more than 2,000 healthcare facilities participate by reporting their quality indicators (in nursing) to the database, including 98% of all Magnet-recognized facilities, which require external QI reporting to maintain Magnet status. Despite becoming the largest provider of unit-level performance data, the program goals remain closely aligned with the ANA’s original intentions, which meant to provide participating facilities with comparative unit-level data for quality analysis while revealing the critical significance of nursing care to patient outcomes.
The National Framework for Nursing QIs: FAQ
By using evidence-backed data to demonstrate the integral relationship between quality nursing care and positive patient outcomes, nursing leaders are better able to advocate for the resources and support they need. If you manage or support nursing teams, this framework may be worth the investment. To help with your decision, we’ll answer some additional questions about the program below.
Which facility types can participate in this specific QI database?
Inpatient and ambulatory healthcare facilities that utilize registered nursing professionals may participate in the national database. Nursing quality indicators within these environments may include catheter-associated urinary tract infections (CAUTIs) from a hospital, or nursing turnover at an ambulatory surgical center.
Although assisted living facilities (and nursing homes) aren’t explicitly restricted from participation — and even track many of the same nursing sensitive indicators — the program is primarily intended for acute and post-acute care providers.
Do any healthcare organizations require NDNQI certification?
The National Database of Nursing Quality Indicators doesn’t offer its participants certification status. It’s simply a data collection and comparative analysis process that facilities can participate in. As a voluntary program, no facilities are required to report to this specific information platform.
However, magnet hospitals (as part of their designation requirement) are mandatory nursing QI reporters. They’re allowed to choose the external database that suits their facility best, and the large majority of Magnet facilities select to disclose nursing-sensitive QIs to Press Ganey’s national database.
How many nursing quality indicators are there?
There are 18 nursing quality indicators listed within the program, grouped under 3 categories of nurse-sensitive measures: structure, process and outcome. The structural measure focuses on staffing, while the process and outcome indicators assess the nursing care quality.
Staffing measures:
- Nursing hours per patient day
- RN education/certification
- Skill mix
- Nurse turnover
- Nursing care hours in emergency departments (EDs), perioperative units, and perinatal units
- Skill mix in EDs, perioperative units, and perinatal units
Quality measures:
- Patient falls
- Patient falls with injury
- Pressure ulcer prevalence
- Healthcare-associated infections (like CAUTIs or ventilator-associated events)
- Psychiatric physical/sexual assault rate
- Restraint prevalence
- Pediatric peripheral IV infiltration rate
- Pediatric pain assessment, intervention, and reassessments
- Falls in ambulatory settings
- Pressure ulcer incidence rates from electronic health records (EHRs)
- Hospital readmission rates
- RN satisfaction surveys (for example, job satisfaction scales and/or practice environment scales)
How is the quality-indicator data reported?
Prevalence and incidence studies are typically carried out by designated nursing teams (through chart audits and patient surveys, for example) in anticipation of the quarterly data reports required by the NDNQI program. All information is then uploaded to the web-based system. However, with the increased prevalence of EHRs, efforts are underway to automate and ease this process.
What is nursing QI data used for?
By creating quality benchmarks and utilizing a national source for comparative information, facility leaders are able to apply a broader scope to unit-level findings. This not only makes for more effective data analysis but also lends evidence to resource prioritization strategies, and other important managerial considerations. The following examples help illustrate these benefits:
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Measures Nursing Quality |
Example: By adhering to benchmark goals for reducing CAUTIs, a nursing unit used the database to more easily track infection rate data and monitor for trends after implementing new catheter care initiatives. They were able to provide measurable evidence that backed the success of their efforts. |
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Improves Nurse Satisfaction |
Example: With increased structured requests for nursing feedback, a psychiatric inpatient unit discovered nursing dissatisfaction with current management communication styles. Changes were made and nursing satisfaction rose with the new flow of information and updates. |
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Builds a Healthier Work Environment |
Example: An ambulatory surgical center discovered a pattern, highlighting increased safety events on days where staffing levels were more restrictive. In response, a new on-call program was implemented, increasing staffing levels and the safety of the work environment. |
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Boosts Reimbursement Potential |
Example: Using the nursing QI data to guide safety initiatives led to better patient outcomes on a nursing unit, securing better reimbursement rates through the Pay for Performance (P4P) payment model. |
Why are nursing quality indicators important (vs. using data from other providers)?
Nurses may not technically be first responders, but they’re consistently on the frontlines of care provided within acute and post-acute environments. By dedicating a platform entirely to the metrics that analyze nursing-sensitive practice standards, systemic focus can prioritize the measures that enhance nursing performance and experiences.
Rather than jeopardize nursing autonomy, this has shown to benefit the nursing experience by better targeting the system-wide challenges that negatively impact nursing workforces.
How can facilities register to participate?
If you’re ready to partner with a national database that can help you track, manage, and compare nursing-sensitive quality indicators to guide better patient care, you may be wondering how to get started. Some helpful database-related links for this particular nursing QI reporting system include:
- Participation demo request.
- National Database of Nursing Quality Indicators enrollment application.
Looking to Refocus Your Quality Improvement Initiatives?
Reporting your nursing quality indicators to the NDNQI is one method of making the most of your data. IntelyCare’s wide range of expert-backed facility guides and best practice recommendations can help you improve patient and organizational outcomes without budgetary strain.