Organizational Systems and Quality Leadership RTT Task 1 Nursing-sensitive Indicators Nursing- sensitive indicators are defined as those outcomes that improve in the presence of greater quantity(higher staffing ratios) or quality(educational levels and competence of nursing staff) of nursing care (www.nursingworld.org). These nursing-sensitive measures help healthcare organizations to analyze the quality and quantity of nursing care services. (www.americansentinel.edu )Nursing sensitive-indicators (NSIs) are characterized by measures that are in the realm of nurses to improve and control. According to the website www.nursingworld.org , in 1998, the National Database of Nursing Quality Indicators was established by the ANA so that …show more content…
J to prevent hospital acquired pressure ulcers. Frequent turning, repositioning, meticulous skin care and assessment are appropriate steps that would be taken to prevent pressure ulcers. The ANA lists patient satisfaction with certain elements of care as a NSI. Patient satisfaction is defined as the measure to which the patient's preferred aspirations and anticipations are accomplished (Fitzpatrick & Kazer, 2012). According to Fitzpatrick & Kazer, 2012, "The patient's subjective evaluation of the cognitive emotional response that results from the interaction between the patient's expectations of nursing care and the perception of the actual nurse behavior/characteristics"(p.388). In the above scenario Mr. J's and his family's desired goals and expectations were not met. Their desire was to have the specific diet as stipulated by their religious beliefs and the expectation was for Mr. J to get the diet he requested. Close attention should have been paid to these goals and requests. The situation was made worse by the nurses' unprofessional response when asked about the slip-up. There is a high relationship linking patient satisfaction on nursing care and satisfaction overall care. For this reason, nurses need to be active participants in quality reporting and in the development of patient satisfaction tools. Restraints prevalence is another NIS that could assist the nurses in the above scenario to identify
There are many resources than can be used in this scenario to alleviate the ethical dilemma presented near the end of the scenario. The patient is Jewish and therefore has a strict diet of Kosher foods. The diet order was originally placed correctly, but the patient was served only partially correct as he did not receive a Kosher meal, but the other aspects of his diet were followed. Diet orders should be checked before bringing patients their food and again with the patient at the bedside. However, the staff never should have tried to “cover it up” and do not understand the implications of the patient eating non-Kosher foods. There are many resources than can
In the hospital environment there are several resources for the nurse to partner with to address nursing sensitive indicators and ethical issues that may arise. In this scenario, to help resolve the issue with meal trays a partnership with dietary could be made to come with an appropriate solution for the correct delivery at meal time. The nurse could have brought this information forward and apologized to the patient and his daughter rather than trying to keep it quiet. The nursing supervisor
Nursing sensitive indicators provide a quantitative and empirical means by which nurses can evaluate the process of care for the patient and so adjust their practice accordingly. In both the case of the excessive use of restraints and making the patient dissatisfied by providing non-kosher food there is an indication that the patient is getting poor care. Without them, nurses would have no way to figure out how to improve the quality of care.
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
While University Hospital is already on the brink of completely preventing pressure ulcers I would still recommend implementing all of the current practices but also add new additions to the team. Currently, we have a wound care team that diligently treats at risk and affected patients. Adding a nutritionist into the team to guarantee treatment from within along with prescribed medications. This will make the team and the strategies multidisciplinary. In addition to that, each treatment should be customized for each patient in regards to cost options and best treatment for their health. The project would also have to be performed repetitively without error to ensure that it is actually helpful. Patients’ skin should continue to be examined thoroughly in common places where ulcers could arise, the standardized pressure ulcer risk assessment should be used, and the proper care should be distributed once evaluated. The team should continue to record its progress and also provide company update emails to inform the facility, as well as send the appropriate data to the higher ups for public posting.
1. Nurse-sensitive performance reviews and quality indicators are vitally important to maintain the health of the nation and the nursing profession in general. Some of the processes used to implement these include monitoring the supply of nursing staff, assessing the skill of such staff, and considering the education or certification of staff. Assessment, intervention, and RN job satisfaction are process indicators that are also important in terms of determining the quality of nursing care at a health facility (ANA, 2012).
Pressure ulcers during a hospital admission are preventable. Assessment and early intervention can stop skin breakdown before it begins. Many factors regarding Mr. J’s condition placed him at a high risk regarding nursing indicators. Mild dementia, recent fall and a fractured hip all require a high level of nursing care and indicates preventative practice. Upon assessment, precautions should be in place to deter further complications. The elderly are more
20). Further, the presence of pressure ulcers places a burden on patients and their family (Grinspun, 2005, p.21). As recommended by Grinspun (2005), pillows and foam wedges to separate prominences of the body and lifting devices have been beneficial to avoid friction (p. 32). Research suggests that the majority of pressure ulcers can be avoided. Although, the population at risk likely suffers from the possible contributors, as stated repositioning at least every 2 hours or sooner was effective (Grinspun, 2005, p. 32). When practicing I will reposition patients at appropriate times to reduce the risk of damage to the skin. Additionally, when moving a patient up in bed, I will request adequate assistance from other nursing staff to use a lifting device. This will help to avoid friction while the patient is being moved, ultimately reducing the development of pressure
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et
A second nursing-sensitive indicator that was clearly overlooked was patient satisfaction with overall care. Defined by the ANA, this is a measure of patient
The Health Care System 's purpose is to meet the physical and mental health needs of the communities in which they serve, these systems operate using people working within heal care facilities as well as other health delivery resources. One group of individual that help with facility operations are nursing administrators. Nursing Administrators contribute in managing along with directing the nursing care delivery system. Their leadership style, characteristics, communication strategies, including the way that they negotiate as well as manage conflicts can determine the quality of the healthcare services treat the facility provide as well as help to develop a set of guidelines to standardize the type and quality of the nursing services. (Cipriano, 2011) Together the Nurse Mangers work toward the same goals along with guiding nurses in their practice and contribute to the facilities successes. (Frankel, 2011) The nursing leaders are advocates who directly affect the quality of the nursing care along with also having a positive impact on healthcare through leadership.
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
Nursing interventions play an important part in the reduction of pressure ulcers. A nurse can help to reduce the risk of pressure ulcers by promoting activity, carrying out skin inspections and assessments, and by using pressure relieving devices (Lynn, 2005). Some patients may fear being dropped when moved using equipment (Rogers, 1999), thus it is important for the Nurse to communicate with the patient, this way the Nurse can explain how the equipment works and the patient can express any concerns that they may have. It is important to remember that not all patients like lifting equipment and
Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.
American Nurses Association, Inc. (2014). Nursing Sensitive Indicators. Retrieved January 2014, from American Nurses Association, Nursing World: http://www.nursingworld.org