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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

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

Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.

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

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.

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.

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.

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.

Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing care. (Nursing-Sensitive, 2014.) The skill level of the nursing staff, the supply of nursing staff, and the education or certifications of the staff are all used to measure the structure of nursing care given to any given patient. Patient outcomes, which are improved by a greater quality of care, are said to be nursing sensitive. Some examples of

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

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).

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

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

American Nurses Association, Inc. (2014). Nursing Sensitive Indicators. Retrieved January 2014, from American Nurses Association, Nursing World: http://www.nursingworld.org

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