Nursing Sensitive Indicators Analysis

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

As a nurse we want to ensure that our patients receive a high quality of care. Patients should feel safe and satisfied while hospitalized. Many hospitals are continually looking for answers and implementation to significantly reduce the inpatient fall incidents. According to Bechdel et al (2014), the top priority of health care organizations nationwide is to reduce and eliminate falls within the clinical care settings. One of the serious problems in acute care hospital is the patient’s fall. The unfamiliar environment, acute and co-morbid illnesses, prolonged bedrest, polypharmacy, and the placement of tubes and catheters are common challenges that place patients at risk of falling. Most of the falls that I have encountered while working involves

Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing

nurse staffing ensures quality nursing care for patients and can be a challenge for nurse

The knowledge of nursing sensitive indicator can be helpful in providing the patient care which meets the quality and ethical standards. Nursing sensitive indicators rely on evidence to take patient care decisions (Patrician, 2010). According to Patrician (2010), Evidence Based Nursing is the use of personal expertise and research to take decisions on patient care. In case of Mr. J, there is a clear lack of evidence based nursing. Mr. J was kept in restraint without considering that Mr. J was not trying to get out of bed by himself. When the pressure ulcer was identified, the nurse

A. Nurse sensitive indicators are factors that are directly impacted by nursing.  There indicators fall into three categories; structure, process and outcomes of nursing care.  The structure indicators are the organizational piece of nursing care. These relates to the amount of staff on duty at a given time, how many RN's are on duty and experience level of the staff. For example, evidence indicates institutions with a higher number of RN’s possessing a Bachelor Degree in nursing result in improved patient outcomes. The process indicators measure nursing care such as patient assessment, patient care and intervention. These are the organizational policies and procedures of nursing.   The patient outcomes are indicators directly related to

Many of these inpatient falls can be prevented when following the proper fall prevention measures. Not only does patient safety make preventing falls a priority but the financial impact these falls have on an institution make it a priority as well.

are a nursing-sensitive indicator which can lead to patient dissatisfaction, maybe not realized by the patient with

Nursing-sensitive indicators consist out of three categories that include the following: Structure, process and outcome. Structure refers to the organizational aspect of nursing that is made up of staffing levels; experience vs inexperience; educational levels or the make-up staffing at any point on the unit or facility. The Process is aspect of policies and procedures at the facility and Outcomes are determined when greater levels of nursing care and quantity are involved with better patient outcomes (ANA, 2015).

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

Over the past decades, various studies world-wide have been conducted on the connection of nursing quality indicators and their outcomes. The

Intervening falls can reduce the financial burdens attributed to patient falls in hospitals and other healthcare settings are among the most serious risk management issues facing the healthcare industry.

A fall can make wide spread consequences on the health service or can be affected seriously by the increased health care utilization. Among the fallers approximately 30% of falls result in physical injury leading to extensive hospitalization with significant hospital expenses (Tzeng & Yin 2010). Preventive care phases can support health services to regulate the spare expenditure to a greater extend. A fall in hospital consequently affects the nursing staff, which lead to impaired job satisfaction, additional work load and startling time consume. As the front line of care, nurses can prevent falls and reduce fall injury rates in acute care unit with available resources (Dykes et al. 2013). This literature review aims to assess the efficiency of planned interventions to reduce the incidence of falls in acute medical units. The discussions of the main findings of the review as well as the recommendations for further research are revealed to conclude this study.

If patient safety is the most important issue in Health Care facilities then how come hospital inpatient falls continue to be the most reported of all accidental falls (Tzeng & Yin, 2009)? Throughout the years, hospitals continue to make changes to decrease the risk of accidents and increase the quality of patient safety. With research studies and improvements made, patient falls still hold the largest portion of reported incidents in hospitals (Tzeng, & Yin, 2008). According to Tzeng & Yin (2008), “fall prevention programs apparently do not effectively reduce inpatient fall rates because of human factors and ergonomics in a hospital environment (p.179, para. 2). The two studies reviewed in this paper were performed with the hopes of

Dr. Avedis Donabedian developed a model for categorizing and measuring the quality of healthcare providing a framework that conceptualized quality in broad terms and classification to measure and assess different aspects of quality in nursing care (Sollecito & Johnson, 2013). In the footsteps of Donabedian’s framework, Dr. Beatrice Kalisch developed a model conceptualizing missed nursing care otherwise known as “unfinished nursing care” or “care left undone”. Missed nursing care as defined in the Missed Nursing Care Model is any aspect of required patient care that is omitted, either in part or whole, or delayed (Kalisch, Landstrom, & Hinshaw, 2009). The structural aspects Kalisch’s model include labor resources, nursing staff, competency level of staff, education and experience, material resources, teamwork and communication. Kalisch model indicates that nurses with recent restricted resources in the nursing process determining clinical priorities is costly making decisions either to delay or omit certain care and is heavily influenced by team perception, nurse judgment, ("Missed Nursing Care AHRQ," 2015).