Quality or Safety Indicators of Care

Summary of the Indicators

It is important to understand this indicator as it applies in hospitals. As Thomas-Hawkins, Latham, and Hain (2017) observe, nursing hours per patient day refers to the actual time that a nurse takes with a patient offering various care services such as giving medicine, determining changes in temperature and blood pressure, and monitoring their general progress. It does not include the time that nurses spend in the office, meetings, or any other official duty away from the patients. In a hospital setting, it is the responsibility of the nurses to monitor the progress of the patients and to address their needs as they emerge, whether they are urgent or otherwise.

They are expected to contact relevant doctors whenever the condition of a patient deteriorates to the extent that they may be in danger. The close observation can only be achieved when a nurse spends quality time with the patients. That is why nursing hour per patient day is increasingly becoming an important indicator of quality in hospitals today.

Care coordination is another quality indicator in a hospital setting. According to Martinez, Battaglia, Stat, Mastal, and Matlock (2015), care coordination refers to the ability of nurses, doctors, and other clinical staff to work in an integrated manner when offering care to the patients. Nurses need to take instructions from doctors on how to care for their patients. Doctors need information from nurses about the progress a patient is making on a daily basis.

Nurses may need assistance of other clinical staff in ensuring that patients get quality care. All these medical practitioners need to work very closely and in an integrated manner to ensure that they deliver the best quality. Proper care coordination system is often characterized by efficient communication among the practitioners, mutual respect, and understanding of the job at hand. The priority of all these practitioners should be to ensure that the patients register quick recovery.

Hospital readmission rates is another critical quality indicator. Patrician, Loan, McCarthy, Brosch, and Davey (2010) say that hospital readmission rates refer to the frequency with which patients revisit hospital with same problem for which, they were treated and discharged. It is always the expectation of medical practitioners that once a patient is discharged, he or she should not be readmitted after a short period because of the same problem.

The patient should be charged when the doctors and the nurses are convinced that his or her condition is stable enough and that the recovery process can be completed through admission of drugs while at home. Before such a patient is discharged, it is expected that he or she will be advised on self-care, especially when and how to take their medication. When hospital readmission rates are high, it is a sign that the doctors, nurses, and other clinical officers who handle these patients are not doing effective work of eliminating the medical problems.

Example of How the Indicators are Measured

The three indicators are critical when determining the performance of nurses, and can be measured in different ways. Nursing hours per patient per day can be measured by calculating the actual time that nurses take when handling a patient within twenty-fours hours. As a standard practice in most hospitals around the country, nurses are always at work for 8 hours in a day. It means that within one day, a patient will be handled by three nurses.

The time that all the three nurses spend with a patient in a day determines nursing hours per patient day. Care coordination is measured by the ease of communication among the care providers, especially when moving from one shift to another. It also involves the technologies that helps the medical practitioners share patient data. Hospital readmission rate is measured by calculating the number of patients who revisit the hospital in a year with medical problems for which they had been treated and discharged.

Determining if the Indicators are New to Clinical Practice

It is important to note that all the three indicators identified in this study are not new in clinical practice. Nursing hours per patient day is an indicator that has been very common in clinical practice. Various unions of nurses have been demanding for the increase of the number of nurses to help them spend quality time with their patients. Most of the nurses strikes are often caused by the fact that they are strained as the number of patients continue to increase without an equivalent increase in the number of nurses (Martinez et al., 2015). Care coordination is not a new indicator. The fact that the medical practitioners appreciate the need for care coordination has led to the emergence of communication technologies in this sector. In the past, physical files and verbal communication were used. However, things are getting digitalized in the modern society. Hospital readmission is also not new. A study by Martinez et al. (2015 ) looked at how to reduce hospital readmission rates by improving quality of service delivery.

How the Indicators Apply to Daily Nursing Practice

The need to improve quality of care in clinical facilities has led to the emergence of nursing-sensitive indicators used to measure performance of the medical practitioners. One of the patient-centered indicators common in hospitals today is nursing hours per patient day. The time that a nurse spends with a specific patient addressing his or her medical needs and monitoring the recovery progress is critical in determining quality of care.

When a hospital has adequate staff, every patient will get quality time with the nurses, and it is expected that the service will be of high quality. On the other hand, when the staff is strained, it becomes difficult to meet personal needs of every patient. Leading hospitals are now keen on ensuring that their patients get adequate attention from the nurses. It makes it easy to monitor the progress of every patient, especially the inpatients who need specialized care.

Care coordination is another important quality indicator in a hospital setting. It is important for the caregivers to work very closely when handling patients to avoid errors of omission or commission. Nurses must coordinate closely among themselves, especially when changing from one shift to another. The patient handover process should involve proper communication where the incoming nurse is fully updated about the patient’s progress, what has been done, and what needs to be done (Thomas-Hawkins et al., 2017). The nurses should also be able to coordinate with other clinical officers and the doctors about the condition of a patient.

The doctor’s report and recommendations about a patient should always be available for the nurses. On the other hand, the regular assessments of the patient made by the nurses should be presented to the doctor before he or she can see the patient. The improved communication makes it easy to offer quality service to patients in hospitals.

In the daily nursing practice, hospital readmission rates is an undesirable occurrence because it reduces the time that medical practitioners should get with their patients. Once a patient is treated for a given health problem, it is expected that they would not revisit the hospital after a short period with the same problem. However, sometimes such eventualities are not avoidable (Thomas-Hawkins et al., 2017).

It is important for doctors, nurses, and other clinical officers to work closely together and in an effective manner to ensure that readmission rates are kept as low as possible. That can only be done by ensuring that when patients visit the hospital, a proper diagnosis is done and medication administered to treat the condition. The patient should be discharged only after it is ascertained that he or she is on the path towards recovery. Nurses should ensure that the patients understand what they need to do once they are discharged as a way of enhancing self-care away from the hospital.


Martinez, K., Battaglia, R., Stat, R., Mastal, M., & Matlock, A., (2015). Nursing-sensitive indicators in ambulatory care: Perspectives in ambulatory care. Nursing Economics, 33(1), 59-63.

Patrician, P., Loan, L., McCarthy, M., Brosch, L., & Davey, K. (2010). Towards evidence-based management: Creating an informative database of nursing-sensitive indicators. Journal of Nursing Scholarship, 42(4), 358-366.

Thomas-Hawkins, C., Latham, C.E., & Hain, D.J. (2017). Emphasizing the value of nephrology nursing through nursing-sensitive indicators: A call for action. Nephrology Nursing Journal, 44(4), 317-325.

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NursingBird. (2022, September 17). Quality or Safety Indicators of Care. Retrieved from https://nursingbird.com/quality-or-safety-indicators-of-care/


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"Quality or Safety Indicators of Care." NursingBird, 17 Sept. 2022, nursingbird.com/quality-or-safety-indicators-of-care/.


NursingBird. (2022) 'Quality or Safety Indicators of Care'. 17 September.


NursingBird. 2022. "Quality or Safety Indicators of Care." September 17, 2022. https://nursingbird.com/quality-or-safety-indicators-of-care/.

1. NursingBird. "Quality or Safety Indicators of Care." September 17, 2022. https://nursingbird.com/quality-or-safety-indicators-of-care/.


NursingBird. "Quality or Safety Indicators of Care." September 17, 2022. https://nursingbird.com/quality-or-safety-indicators-of-care/.