[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Care management](https://durgical.com/en/nursing/areas/management/) › Quality of nursing care: indicators and how they are measured # Quality of nursing care: indicators and how they are measured - Fundamental A quality indicator is a number, built the same way every time, that shows how often something good or bad happens in care. Updated Nov 12, 2026 ## Key points - Every indicator has a numerator, a denominator, a period and a multiplier (per 100 = percentage; per 1,000 = rate per 1,000). - Inpatient fall rate (Res. 256 de 2016): patients who fall in the period ÷ total patient-days in the period × 1,000. - Catheter bloodstream infection rate: new infections in the month ÷ central-line days in the month × 1,000. - Nursing-sensitive indicators: falls, pressure injuries, catheter infections, medication events and patient experience. - Res. 256 de 2016 groups indicators into four domains: effectiveness, safety, risk management and experience of care; reporting is every six months. ## What it is Quality indicators turn care into numbers a unit can follow over time and compare. Nursing-sensitive indicators are the ones nursing care can change most: patient falls, pressure injuries, catheter-associated infections, medication events and the patient's experience of care. Each indicator has a fixed definition: a numerator (the events counted), a denominator (the population or exposure at risk), a period and a multiplier such as per 100 or per 1,000. In Colombia, Resolución 256 de 2016 sets the indicators of the Sistema de Información para la Calidad, grouped into effectiveness, safety, risk management and experience of care. Its technical sheets define, for example, the inpatient fall rate per 1,000 patient-days and the catheter-associated bloodstream infection rate per 1,000 central-line days. Providers report them every six months and must analyse the results to improve. ## Key points - Numerator: the events that are counted, defined exactly (for example, patients who fell while in hospital). - Denominator: who or what was at risk, in the same place and period (for example, the sum of all patient-days). - Patient-days or device-days are used when the time at risk differs between patients: a long stay gives more chances to fall. - Proportion: part of a whole, expressed per 100 (%). Rate: events per unit of exposure, often per 1,000 patient-days or device-days. - Indicators only compare fairly when the definition, the period and the denominator are the same. - A rate is a signal to investigate, not a verdict: the team looks at the trend and the causes behind it. ## Components - Name and definition of the indicator. - Numerator and its data source (for example, the provider's own reports). - Denominator and its data source (for example, the record of patient-days). - Unit of measure, period and how often it is reported. - Domain it belongs to: effectiveness, safety, risk management or experience of care. ## What it is for - Shows whether care is getting safer or worse over time. - Points improvement work (PDCA cycles) at the problems that matter most. - Lets institutions compare themselves with their own past results and with national data. - Gives patients and regulators information about the quality of providers. ## Nursing-sensitive indicators and how they are built (Res. 256 de 2016 technical sheets), with a made-up worked example | Indicator | Numerator | Denominator | Unit | Made-up example | | --- | --- | --- | --- | --- | | Inpatient fall rate | Hospitalised patients who fell in the period | Sum of patient-days in the period | Per 1,000 patient-days | 6 falls ÷ 2,400 patient-days × 1,000 = 2.5 per 1,000 patient-days | | Catheter-associated bloodstream infection rate (ICU) | New infections in a month | Central-line days in the month | Per 1,000 central-line days | 2 infections ÷ 800 line-days × 1,000 = 2.5 per 1,000 line-days | | Adverse events related to medication administration (emergency department) | Adverse events related to giving medicines | People seen in the emergency department in the period | Per 100 (%) | 3 events ÷ 1,500 people seen × 100 = 0.2% | | Pressure injury rate | Patients who develop a pressure injury in the institution in the period | Sum of patient-days in the inpatient services | Per 1,000 patient-days | 3 patients ÷ 2,400 patient-days × 1,000 = 1.25 per 1,000 patient-days | | Overall user satisfaction | Users who answer «very good» or «good» to the question on their overall experience | Users who answered the question | Per 100 (%) | 180 ÷ 200 × 100 = 90% | ## In nursing practice - Nurses produce most of the numerator data: each fall, pressure injury or medication event they record becomes part of an indicator. - Incomplete reporting makes a unit look safer than it is; a rising count after a reporting campaign can mean better reporting, not worse care. - Results are analysed with the team every six months at least, and turned into improvement actions. - Open RN lists collecting data to monitor nursing quality and taking part in quality improvement as part of the nurse's role. ## Common mistakes - Comparing raw counts between wards of different size instead of rates. - Changing the definition or the denominator halfway through the year. - Using the number of beds instead of patient-days as the denominator of a fall rate. - Hiding events to keep the indicator low. - Collecting the data and never feeding it back to the staff who produced it. ## Test yourself Think of the answer, then tap the question to see it. ## How is the inpatient fall rate built in Colombia's Resolución 256 de 2016? Hospitalised patients who fell in the period, divided by the total patient-days in the same period, multiplied by 1,000. ## A ward had 4 patients who fell and 2,000 patient-days in a semester. What is its fall rate? 4 ÷ 2,000 × 1,000 = 2 falls per 1,000 patient-days (a made-up teaching example). ## Why are patient-days used as the denominator instead of the number of patients? Because the time at risk differs: a patient who stays longer has more days in which a fall can happen. Patient-days make wards of different sizes and stays comparable. ## Which four domains group the indicators of Resolución 256 de 2016? Effectiveness, safety, risk management and experience of care. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/quality-of-nursing-care-indicators-and-how-they-are-measured/) ## Connections ## Related 6 - [The PDCA (PHVA) cycle in nursing services](https://durgical.com/en/nursing/the-pdca-cycle-in-nursing-services/) - [Adverse events: reporting, analysis and a just culture](https://durgical.com/en/nursing/adverse-events-reporting-analysis-and-a-just-culture/) - [Preventing falls: risk assessment and measures](https://durgical.com/en/nursing/preventing-falls-risk-assessment-and-measures/) - [Preventing pressure injuries: risk scales, repositioning and skin care](https://durgical.com/en/nursing/preventing-pressure-injuries-risk-scales-repositioning-and-skin-care/) - [Preventing healthcare-associated infections: the care bundles](https://durgical.com/en/nursing/preventing-healthcare-associated-infections-the-care-bundles/) - [Colombia's mandatory health-care quality system: habilitación, auditoría and acreditación](https://durgical.com/en/nursing/colombia-s-mandatory-health-care-quality-system-habilitacion-auditoria-and-acred/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Resolución 256 de 2016, Sistema de Información para la Calidad e indicadores para el monitoreo de la calidad en salud](https://www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%200256%20de%202016.pdf) (Ministerio de Salud y Protección Social (MinSalud), Colombia, 2016); [Fichas técnicas de los indicadores de la Resolución 0256 de 2016](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/fichas-tecnicas-indicadores-resolucion-0256-2016.pdf) (Ministerio de Salud y Protección Social (MinSalud), Colombia, 2017); [Nursing Management and Professional Concepts, 9.2 Quality Care](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Management_and_Professional_Concepts_1e_(OpenRN)/09%3A_Quality_and_Evidence-Based_Practice/9.02%3A_Quality_Care) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts edition, 2022); [Quality health services (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/quality-health-services) (World Health Organization (WHO), 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/quality-of-nursing-care-indicators-and-how-they-are-measured/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/quality-of-nursing-care-indicators-and-how-they-are-measured/