Nursing Sensitive Quality Indicator Data Collection Checklist
Systematic collection of nursing-sensitive quality indicators for benchmarking and quality improvement.
- Industry: Healthcare
- Frequency: Monthly/Quarterly
- Estimated Time: 30-45 minutes
- Role: Quality/Nursing Leadership
- Total Items: 32
- Compliance: NDNQI, ANA National Database, CMS Quality Measures
Patient Falls
Fall data
- Total falls documented?
- Falls with injury documented?
- Patient days calculated?
Pressure Injuries
HAPU data
- HAPU count documented?
- Prevalence survey completed?
Healthcare-Associated Infections
Infection data
- CAUTI data collected?
- CLABSI data collected?
- Device days documented?
Restraint Use
Restraint data
- Restraint prevalence documented?
- Restraint-related injuries documented?
Pre-Assessment Information
Initial assessment documentation and patient/facility identification
- Assessor Name / Credentials
- Assessment Date
- Department / Unit
- Assessment Type (Routine/Annual/Complaint)
- Previous assessment findings reviewed?
Infection Prevention & Control
Verify infection control practices per CDC and Joint Commission standards
- Hand hygiene compliance observed?
- Appropriate PPE available and properly used?
- Isolation precautions properly implemented?
- Sharps containers available and not overfilled?
- High-touch surfaces properly disinfected?
Patient Safety & Identification
Verify patient safety protocols and identification procedures
- Two patient identifiers used before procedures?
- Fall risk assessment completed?
- Call light within patient reach?
- Bed in lowest position with brakes locked?
Medication Safety & Management
Verify medication handling and administration practices
- Medications stored securely and at proper temperature?
- Controlled substances properly secured and counted?
- No expired medications in stock?
- High-alert medications properly labeled?
Environment of Care & Safety
Verify facility environment meets safety standards
- Fire exits clear and unobstructed?
- Emergency equipment functional and accessible?
- Spill kits available and stocked?
- Electrical cords and outlets in safe condition?
Related Healthcare Checklists
- Quality Improvement Project Plan Checklist
- Clinical Documentation Improvement Checklist
- Nursing Competency Verification Checklist
- Nursing Peer Review Checklist
- Interpreter Services Documentation Checklist
- Modified Early Warning Score (MEWS) Assessment Checklist
- Blood Glucose Monitoring Protocol Checklist
- Medical Staff Credentialing Verification Checklist
Related Quality Assurance Checklists
- Nursing Peer Review Checklist - FREE Download
- Medical Device Incident Report Checklist - FREE Download
- Hospital-Acquired Condition Prevention Checklist - FREE Download
- Sentinel Event Investigation Checklist - FREE Download
- Hospital Safety Daily Leadership Rounds Checklist - FREE Download
- Quality Improvement Project Plan Checklist - FREE Download
- Clinical Documentation Improvement Checklist - FREE Download
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Why Use This Nursing Sensitive Quality Indicator Data Collection Checklist?
This nursing sensitive quality indicator data collection checklist helps healthcare teams maintain compliance and operational excellence. Designed for quality/nursing leadership professionals, this checklist covers 32 critical inspection points across 9 sections. Recommended frequency: monthly/quarterly.
Ensures compliance with NDNQI, ANA National Database, CMS Quality Measures. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Nursing Sensitive Quality Indicator Data Collection Checklist cover?
This checklist covers 32 inspection items across 9 sections: Patient Falls, Pressure Injuries, Healthcare-Associated Infections, Restraint Use, Pre-Assessment Information, Infection Prevention & Control, Patient Safety & Identification, Medication Safety & Management, Environment of Care & Safety. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed monthly/quarterly. Each completion takes approximately 30-45 minutes.
Who should use this Nursing Sensitive Quality Indicator Data Collection Checklist?
This checklist is designed for Quality/Nursing Leadership professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.