The nurse sensitive indicator is measured by The National Database of Nursing Quality Indicators (NDNQI). Pressure ulcer prevalence is one of the nurse-sensitive indicators measured. It’s branched into community acquired, hospital acquired and unit acquired. Through unit base pilot testing, the data is able to be collected and measured. This organization has a skin committee who goes to each patient in the hospital with a pressure ulcer and assesses the condition that’s reported back to the committee for further analysis. They also have developed a new position in the hospital that consist turn team members. These individuals are staffed throughout the hospital 24 hours a day and turn each patient that’s on the turn team list every two hours.
Now, the quality improvement department will need to determine what processes can be modified to improve outcomes. For example, if they see an increase in pressure sores and prevalence of restraints. They could use computerized charting and order entry, along with the evidence-based guidelines, to identify specific groups of patients who are vulnerable to developing pressure ulcers or closely monitoring use of restraints. With early identification, automatic orders for preventive interventions can be implemented quickly. With the assistance of the automated consults and orders, the appropriate equipment, the interdisciplinary task force, continuing education, and monitoring, the hospital system would be able to reduce unnecessary use of restraints and hospital-acquired pressure ulcer prevalence rate (Cherry & Jacob, 2010).
Studies have pointed out that nurses possess a significant role and extensive knowledge in pressure ulcer prevention. Instructive programs in the hospitals give great learning to nurses about the preventive and treatment techniques for
Hospital data on specific nursing-sensitive indicators can help a facility advance quality patient care and prevent any new adverse events through education, increased staff, acknowledgement, and accountability. The healthcare facility can post these indicators and the data associated with them including location in the facility and staffing numbers. This helps to bring these indicators to a more individual level whether it be per unit or per person. This along with acuities helps to justify the need for larger numbers in staffing. Although facilities would sometimes rather work with minimum staffing allowed, it is necessary to show that with more staff patients are receiving a higher level of quality care. These numbers might reflect this. This data might also compare the number of hospital acquired pressure ulcers with the use of restraints. This might show staff another reason for promoting a restraint free environment. It must be stressed to nursing staff that they have a direct impact on these nursing-sensitive indicators. Nursing staff could be educated on prevention and early detection of any indicators.
This study evaluates the decision making of nurses in relation the prevention and management of pressure ulcers. There are many assessment tools create to help nurses assess the level of risk a patient have, and from there, they can create a plan of care in pressure ulcer prevention.
The primary goals for conducting nursing research are to generate new knowledge to promote positive outcomes for patients, enhance quality and cost-effectiveness of care, improve the healthcare delivery system, and validate the credibility of the nursing profession through evidence-based practice (Schmidt & Brown, 2012). The purpose of this paper is to explore the practice-related problem of pressure ulcers and the importance of the problem in the nursing profession.
Although the situation was quite challenging, it provided me with some useful experiences for the future practice. I understand that all institutions should have a policy for documenting the assessment of patients, including pressure ulcers (Morison 2001). I have come to be familiar with the homes assessment policy using the Sterling Pressure Sore Severity Scale and most importantly I have learned that by using a universal assessment tool it supports a systemic and consistent approach to pressure ulcer evaluation. This therefore supporting continuity of care.
Nursing sensitive indicators (NSI) were developed by the American Nurses Society (ANA )in the 1990’s as a way to link patient outcomes to nurse staffing (Montalvo, 2007). NSI established parameters to focus on and to provide a means to evaluate the care given by nursing (Nursing sensitive indicators, 2013). The scenario might have ended differently if the NSI had been adhered to and utilized. NSI’s have shown if a certain process are followed then a certain outcome would be achieved. The value of use of an already identified process are that evidence has shown that these processes are effective (NSI, 2013). The pressure ulcer and restraint use are under the NSI. The outcome for the patient are shorter hospital stays, respectful treatment, and cost-effective care.
Nursing sensitive indicators are identified as steps towards standardized measurements of nursing care, which provides details about the relationship between qualities of healthcare given to patients (ANA, 2011). Today healthcare strives to provide great quality service to the patrons of the community. Everyone knows that providing quality healthcare care plays a dramatic role in encouraging helpful patient outcomes. It also important to remember the way nursing sensitive indicators are delivered has a major influence on the patient. It has been known that nursing care standards were identified through the nurse sensitive indicators.
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid,
Fortunately, according to Chan et al., (2008), 95% of pressure ulcers can be prevented and nursing care is believed to be a primary method of preventing pressure ulcer development. Research was conducted on accredited search databases such as CINAHL, Nursing Resource Center and OvidSP on prevention measures for pressure ulcers. A number of credible evidence based research was found that supported the nursing intervention of
Great post! I must tell you that I was very impressed with your work place and the implementation of staff nurses that are responsible for assessing those patients who are at risk for pressure ulcers. How so? At my place of employment, every nurse assigned to a patient is totally responsible for following the Braden scale to the max. This is done on every shift; it would be nice if we have nurses from the wound and colostomy care team that work at nights. This would prevent a backlog of patients waiting for skin consultation. I believe that the longer a client waits to have his or her skin assess for pressure ulcer, the greater the chance for having the skin compromised. It is great that at your work place there are nurses that work
I am doing my evidence-based paper on why it is important to prevention of pressure ulcers in intensive unit. It’s important in nursing care because you see it everywhere not just intensive care, but hospitals, nursing homes, and people at their own homes. Patients in the intensive care units are usually end up with the most
Nurses are integral key players in multidisciplinary teams caring for patients in complex healthcare systems. Hospitals, a primary care delivery portal within the health system, are inundated with patients requiring higher acuity care. Nurses must be prepared to recognize patients’ health care needs and provide quality patient care outcomes. The knowledge of nursing sensitive indicators can be helpful in providing the care which meets quality standards. Nursing sensitive indicators rely on evidence-based practice. The American Nurses Association created a repository for implementing, developing, and
The study that was done shows that there is a significant inverse relationship between nurse staffing and the number of patients who sustain falls or pressure ulcers while hospitalized. The findings have proven that the more nursing staff on during a shift, the less falls and pressure ulcers occurred (He, Staggs, Bergquist-Beringer, & Dunton, 2016).
It was during my first week clinical placement in the ward when I came across with the Waterlow risk assessment tool. My mentor made sure that I got all the risk assessment tools commonly used in the ward as these will play a key part in my duty as a qualified staff nurse. True enough, this risk assessment tool became visible in every patient’s charts and serial risk assessment was done on a weekly basis.