Organizational Systems

A) There are several issues in the case of Mr. J that need to be examined. Using nurse sensitive indicators “reflect patient outcomes that are determined to be nursingsensitive because they depend on the quality or quantity of nursing care” (American Sentinel University, 2011). Mr. J. was not receiving acceptable care, because his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. This skin condition is the first stage of a developing pressure ulcer. a. Nurses should be aware that a patient with limited mobility is at risk for skin breakdown, and pressure ulcers.

care outcomes, as well as benchmark data to assess current practice,” (Sherwood, 2014). American Nurses Association has a National Database of Nursing Quality Indicators looks for a cause for common healthcare issues, such as “surgical site infections, pain assessment, pressure ulcer development, and falls,” (Sherwood, 2014) to better understand how these things came about to possibly prevent in the future.

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

Nursing sensitive indicators reflect the structure, process and outcomes of nursing care. The structure of nursing care is indicated by many factors such as supply of staff, education level and quality of care provided. Process indicators measure aspects of nursing care such as assessment, intervention, and RN job satisfaction. Patient outcomes that are determined to be nursing sensitive are those that improve if there is a greater quantity or quality of nursing care (Nursing world, 2013). In 1999, the American Nursing Association recognized a total of 10 indicators that apply to hospital based nursing care (Americansentinel.edu, 2017). Indicator such as pressure ulcers, patient falls and nosocomial infections are recognized in this list and are considered preventable with proper nursing action. Knowledge of these indicators could have assisted the nurses in several ways involving this case study involving Mr. J.

The hospital acquiring data on the above indicators of pressure ulcer incidence, prevalence of restraints,

By measuring nursing sensitive indicators hospital wide and collecting this information, quality patient care in hospitals can be advanced due to the administrators knowing which areas of practice nurses need to improve. All organizations, including hospitals have institutional cultures, these cultures can potentially have a positive or negative effect on desired outcomes. In the case of hospitals this would be the quality of patient care. If the institutional culture of nurses in the hospital promotes negligence in care, lack of respect for patient autonomy, or poor prioritization, the nursing sensitive indicators should reveal it as for example: negligent care would lead to higher rates of falls and complications acquired during the patient stay.

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

By understanding nursing sensitive indicators, the nurses in this case could improve the structure, process, and outcomes of their nursing care. The structure of nursing care is indicated by the supply of nursing staff and the skill level of the nursing staff. By the nurses having increased knowledge of the issues hip fracture patients are prone to having, such as decrease mobility, increase need for surgical intervention, and increase risk of falls, could help improve the quality of patient care. A patient with decrease mobility is at higher risk for pressure sores. The nurses in this case may have prevented the one by proper

In this given scenario, there are multiple nursing sensitive indicators present including pressure ulcer prevalence, restraint prevalence, and skill mix. (Montalvo, 2007) The most prevalent one for me was pressure ulcer prevalence. Yes, in this case, the pressure ulcer was likely secondary to restraint use, so these tie in together, but pressure ulcers overall are easy to prevent using proper turning and

Another target for the nurse manager to perform is to maintain quality improvement in his or her unit in each feature. According to Hurst, Moore & Clark (2011), “Nurse managers who are strong advocates for developing a healthy work environment may be viewed as risk-takers. The workplace is an important setting for the nursing leader to address the mental, physical, social, and economic welfare of employees” (pp 1). This explains that the nurse manager initially communicates with her workers and has a good relationship as manager-employee relationship and directs the concerns and problems directly in order to deliver a confident setting to work efficiently. So that, the quality improvement will be sustained which will improve the proper care delivery.

The company is geographically located in most major united states locations. It employs a hierarchal organizational design. One of the contributing factors to its success is the company’s success in providing a dining experience for its customers that excel in choices, price, customer service, and serving size. The company is known world-wide for its delicious cheesecakes with the key factor being the variety.

My desired field of study is nursing, so the topic of interest I chose is the prevention of pressure ulcers (Bedsores) in hospitals. While I was going through the scholarly articles, it was a bit hard for me to find a topic that was connected specifically to nursing. After scrolling for a while I came up with this and found it to be incredibly interesting and important! Pressure ulcers affect more than 3 Million adults in today’s hospitals Most of the time pressure ulcers do not cause death, but rather a steady decline in health that can lead to other medical problems. The National Pressure Ulcer Advisory Panel (NPUAP) says that the chance of getting a pressure ulcer in a hospital ranges from .4 to 38 percent, this is not good at all (Lyder,

Studies have shown strong correlations between nurse sensitive indicators or nursing quality indicators and patient outcomes. Nursing sensitive indicators are performance measures that can measure outcomes of nursing care. Nursing indicators can include nursing hours per patient day, patient falls, pressure ulcer prevalence, restraint

Evaluating the quality of nursing practice began when Florence Nightingale identified nursing’s role in health care quality and began to measure patients outcomes. She used statistical methods to generate reports correlating patients outcomes to environmental conditions. Over the years, quality measurement in health care has evolved. The work done in the 1970s by the American Nurses Association (ANA) and of the Quality Assurance have offered a comprehensive method for evaluating health care quality. In the early 1990s, the ANA demonstrated the need for to evaluate nurse staffing and identify the relationship between nurse staffing and patients outcomes. In 1994, a series of studies across the US were funded by ANA to evaluate the relationship between nursing staff and quality of care. Many quality indicators were identified. In 1996 a team of researchers coined the phrase “nursing sensitive indicators” to reflect elements of patient care that are directly affected by nursing practice—and it has become a big word in health are today. Evidence was developed into a final set of ten nursing-sensitive indicators to use in evaluating patient care quality. In 1998, the National Database of Nursing Quality Indicators (NDNQI) was established by ANA so that they could continue to collect and build on data obtained from earlier studies and further develop nursing’s body of knowledge related factors which influence the quality of nursing care.

Reading underachievement with Academically Gifted males has existed in schools for long as the intellectual label has existed. Failure to meet the needs of these students is largely a result of organizational constraints in which school systems find themselves in. Systems are not adequately designed to meet the needs of diverse populations because schools still maintain the status quo of “one size fits all” education, even though they claim otherwise. Meanwhile, state and federal funding acts as a catalyst that drives most every organizational system within the school, and our students remain victims to its stifling structure. Organizations are at the heart of the reaching successful subgroups, and regardless of what external systems