Nursing-sensitive quality indicators describe aspects of care influenced by nursing practice and the environment in which nurses work. They help teams examine resources, care processes and outcomes.
Press Ganey, which provides the National Database of Nursing Quality Indicators, or NDNQI, describes unit-level benchmarking across participating inpatient and ambulatory settings. Its definition links nursing-sensitive indicators with practice, staffing and the work environment.
The term “sensitive” should not be read as proof that nursing alone determines an outcome or that every event can be attributed to one nurse.
Distinguish structure, process and outcome
A foundational account by the nurse responsible for NDNQI oversight describes structural measures, such as nursing hours, alongside processes and outcomes. It explains the importance of common definitions and evaluating care at the unit level. This is a historical explanation published in 2007, not a current indicator manual.
Use the categories to ask different questions. Structure concerns the resources or context of care. Process concerns what is done. Outcome concerns what happens.
A useful review connects these questions without assuming that a trend in one automatically proves the cause of a trend in another.
Read the measure definition first
Before discussing a result, establish exactly what is counted. Identify the event or activity, the unit, the time period, the denominator and any exclusions.
A count of events, a count of people experiencing events and a rate based on patient-days are different quantities. Repeated events involving one person make the distinction especially important.
For an explicitly fictional example, three qualifying events during 1,500 patient-days produce a rate of 2 events per 1,000 patient-days: three divided by 1,500, multiplied by 1,000. This illustrates arithmetic only. The official measure specification determines which events and days qualify.
Compare compatible data
Press Ganey describes comparison groups within NDNQI and opportunities to examine unit-level results.
When reviewing a benchmark, ask which settings and populations are included and whether the definitions match the local data. Keep the comparison period and any method changes visible.
Check missing information and data corrections before interpreting a sudden change. An improvement in recording can alter a reported rate even when the underlying care process has not changed in the same way.
Use the organization's authorized current specifications. A general wiki article cannot replace a database's operational definitions or licensed reporting materials.
Move from measurement to investigation
Bring the data together with staff observations, patient information and a review of the relevant workflow. Identify a specific question the team can investigate.
Avoid using a single number as a complete account of a unit or an individual. Ask what changed, which other factors may matter and what evidence would help distinguish among explanations.
When a change is introduced, preserve the measure definition and evaluate its intended effects alongside possible unintended ones.
For help determining what an indicator actually measures, compare structure, process and outcome measures.
Related pages cover quality nursing, measuring care coordination and Magnet recognition.
Sources
- National Database of Nursing Quality Indicators (accessed 2026-09-17) — Press Ganey.
- The National Database of Nursing Quality Indicators (accessed 2026-09-17) — Isis Montalvo, OJIN, September 30, 2007.