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COVID-19 Pandemic Increases in Nurse-Sensitive Quality Indicators.
Lake, Eileen T; Pascale, Angela; Warshawsky, Nora E; Smith, Jessica G; Staiger, Douglas; Rogowski, Jeannette A.
Afiliação
  • Lake ET; University of Pennsylvania School of Nursing, Philadelphia, PA.
  • Pascale A; Press Ganey Associates LLC, South Bend, IN.
  • Warshawsky NE; Press Ganey Associates LLC, South Bend, IN.
  • Smith JG; University of Texas at Arlington, College of Nursing and Health Innovation, Arlington, TX.
  • Staiger D; Department of Economics, Dartmouth College, Hanover, NH.
  • Rogowski JA; The Pennsylvania State University, State College, PA.
Nurs Res ; 2024 Aug 16.
Article em En | MEDLINE | ID: mdl-39162599
ABSTRACT

BACKGROUND:

The pandemic profoundly stressed nursing practice and could have thereby affected trends in nurse-sensitive quality indicators (NSIs), measures that detect changes in patient health status directly affected by nursing care.

OBJECTIVES:

To determine if NSIs have worsened in response to the pandemic and then returned to pre-pandemic levels using data from 2019 through 2022.

METHODS:

We conducted a cross-sectional descriptive study of annual trends, examining unit data from the National Database of Nursing Quality Indicators (NDNQI) from 2019 through 2022 for five indicators rates of falls, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), hospital-acquired pressure injury (HAPI), and ventilator-associated events (VAE). The NDNQI is the largest repository of nursing quality indicators, which are derived from patient-level events, reported at the nursing unit level, and submitted quarterly by over 2,000 member hospitals. Adult medical-surgical or critical care inpatient nursing units with complete data for the 4 years were included, with samples ranging from 456 to 5,818 nursing units in 2,346 hospitals. Analysis of variance was conducted by comparing the 2019 rates to each subsequent year.

RESULTS:

In decreasing order of prevalence, the mean pre-pandemic rates were 6.58 VAE per 1,000 ventilator days (critical care only), 2.41 HAPI per 1,000 device days, 2.20 falls per 1,000 patient days, 0.96 CAUTI per 1,000 catheter days, and 0.68 CLABSI per 1,000 central line days, for medical-surgical and critical care units combined. The rates for all five nurse-sensitive indicators increased significantly beginning in 2020 and have begun to decline but have not returned to baseline by 2022. The maximum rate was observed in 2020 for falls and 2021 for the remaining indicators. These increases to the maximum ranged from a 12% percent increase in CAUTI to 49% for CLABSI.

DISCUSSION:

NSIs increased during the pandemic and are now returning to baseline. The pandemic underscored the importance of nursing practice. The pandemic's enduring negative effects on the nursing workforce must be addressed to preserve patient safety.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Nurs Res Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Nurs Res Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos