Nursing Sensitive Quality Indicators in the Perinatal Setting

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Primary Author:</td>
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Sara M. Vecchione, MS, RNC-OB</td>
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Co-Principal Investigators/Collaborators:</td>
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Brenda Baker, PhD</td>
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Organization:</td>
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Virginia Commonwealth University Health System</td>
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Abstract</h2>
<h3>
Purpose</h3>
<p>Develop nursing sensitive quality indicator in the perinatal setting.</p>
<h3>
Background</h3>
<p>Perinatal areas have struggled to identify nursing sensitive indicators that are meaningful and representative of the care provided. National indicators and benchmarks have primarily focused on topics common in the medical/surgical and critical care areas of nursing. In an effort to measure and improve the valuable care provided in Labor and Delivery (L&D), the unit based Nursing Quality Committee at an urban academic hospital developed a Quality Dashboard of indicators that are specific to perinatal nursing care.</p>
<h3>
Materials & Methods</h3>
<p>A review of literature on nursing sensitive quality indicators revealed limited recommendations specific to L&D. Indicators were identified from a review of hospital wide indicators, Institute for Health Improvement (IHI) evidenced-based care bundles, national trends, and event reports with relevance to L&D. The unit based Nursing Quality Committee developed the following dashboard of indicators for the perinatal setting: retained material after vaginal or cesarean delivery, perinatal falls, maternal and neonatal hypothermia, newborn skin-to-skin following both vaginal and cesarean deliveries, surgical safety, and management of tachysystole associated with the use of oxytocin. Data is collected monthly through retrospective chart reviews. </p>
<h3>
Results</h3>
<p>Benefits of perinatal specific indicators include: improvement in patient outcomes, engagement of staff in data collection that is meaningful to practice, and data driven decision making. Data included in the L&D Quality Dashboard has been used to guide the purchase of new equipment for the unit, facilitate design of a new Labor and Delivery Suite, develop interdisciplinary simulation training, and initiate a nursing research project related to falls in the perinatal population. </p>
<h3>
Conclusion</h3>
<p>The L&D Quality Dashboard is a dynamic tool that has improved patient outcomes, enhanced communication between staff, leadership, and administration. It has empirically guided decision making and promoted accountability at the bedside and among leaders to transform practice in the perinatal setting. </p>
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<h3>
Bibliography</h3>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>