Organizational Systems and Quality Leadership Task 1 Western Governors University A. Embedded in the founding principles of nursing is the responsibility of nurses to measure, evaluate and improve practice. Hospitals use data and clinical tools to compare themselves to other healthcare organizations in an effort to achieve quality patient outcomes. Having an understanding of the principles of nurse-sensitive indicators, organizational leaders can advance patient care throughout the hospital. A. Nursing-Sensitive Indicators Healthcare organizations and regulatory agencies recognized a relationship between nursing interventions and overall quality of patient care in the mid 1990’s (Erickson, 2011). This is when nursing-sensitive indicators (NSIs) were introduced as a means to measure patient outcomes.
In the care of the patient Mr. J, utilizing nursing-sensitive indicators could have greatly assisted the nurses and aids in identifying issues that may interfere with patient care and cause negative patient outcomes. The ANA has defined a number of nursing-sensitive indicators in the National Database of Nursing Quality Indicators (NDNQI). The national database program collects these designated indicators and analyzes their prevalence in an effort to prevent these negative patient outcomes and make recommendations about how they may be avoided (ANA, 2009). There were a number of errors made in the patient’s care, and closer adherence and understanding of these guidelines would have proven useful in guiding these personnel in his care. Without paying attention to these quality indicators, some care may have fallen through the cracks, some may have not been identified in a time-frame that was meaningful or useful, and much of the care the patient received may have been detrimental to his condition.
A Failure Modes and Effects Analysis (FMEA) will be used to project the likelihood that the suggested improvement plan would not fail. Lastly, key roles nurses would play in improving the quality of care in the Mr. B scenario will be discussed. A. Root Cause Analysis A root cause analysis (RCA) is “a process for identifying the basic or causal factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event” (Cherry & Jacob, 2011, p. 442). The participants during the root cause analysis would be the emergency room physician (Dr. T.), the Mr. B’s LPN and RN (Nurse J) during the time of the sentinel event, the emergency room nurse manager, and the chief nursing officer (CNO) of the hospital. These members would meet in a root cause analysis meeting to discuss the causative factors that created Mr. B’s sentinel event.
Recognizing at restraint use is a nursing specific indicator can help the staff in this situation develop an appropriate care plan. Having a set care plan makes it possible to easily identify when care is beginning to deviate from the care plan, resulting in lower quality patient care as well as risking patient safety. Quality indicators should be used to standardize all care for patients in restraints, making it less likely for the staff in this situation to experience issues. Another important indicator that can be used in this scenario is the prevention and management of pressure ulcers (Montalvo 2007). Nurses play an important role in the prevention of pressure ulcers.
You feel like taking you sweater off? I was punishing someone, but it ended up being you. He collapsed the second his head hit the pillow. You and daddy had a sleepover? I told you that you could not stay over Do you think it might have been triggered by the anxiety of the baby?
RTT Task 1 Alisha Diehl Western Governors University RTT Task 1 Nursing-sensitive indicators are utilized in healthcare to increase quality patient care, as well as patient safety. They reflect the organization, procedure, and products of patient care. In the presented scenario involving Mr. J, nursing-sensitive indicators can be used to identify the issues that interrupted the flow of quality patient care. Understanding Nursing-Sensitive Indicators A solid understanding of nursing-sensitive indicators can assist the nurses in the case of Mr. J in identifying issues that may interfere with patient care. Knowledge of appropriate restraint use, as well as the care involved while caring for a patient in restraints, and prevention of pressure ulcers could have prevented some of the issues in this scenario.
The theory is a framework that healthcare professionals can use to provide a basis for self-care and symptom management in the chronic disease patient. Keywords theory analysis, UCSF Symptom Management Theory, Symptom Management Model, chronic illness, chronic disease Introduction Symptom Management and its relationship with chronic disease has been named a research priority in the nursing profession (NNRA Process, 2006). The development of theories to guide research and Evidence Based Practice in this area is crucial, with further progress through analysis and application to practice. The UCSF Theory of Symptom Management (SMT) provides the guidance for the nurse to understand patient symptoms with better assessment, support and treatment in nursing practice. The symptom is usually what brings the patient to seek out health care (Humphreys et al., 2008) and adherence to treatment by the patient is crucial.
Mitigating Lateral Violence: Design for Change in Practice Stacy Lacaillade Chamberlain College of Nursing NR451 Capstone Course 28 November, 2010 Design for Change in Practice Evidenced based practice (EBP) is an empowering process for improvement in the health care professions. Rosswurm and Larrabee (1999) credit the research studies which used meta - analysis, randomized clinical trials and systematic studies of patient outcomes over the last few decades as having started this shift from the “tradition of intuition – driven practice…to the new paradigm of evidenced based practice” (p.318). However, evidence has encountered a certain amount of difficulty being implemented into practice, thereby necessitating the use of a model when implementing a change based on evidence into practice. This paper will discuss the six steps in the Rosswurm and Larrabee (1999) model for implementing change as they apply to the necessary change of mitigating lateral violence in the nursing work place. Step 1: Assess This step of the change process begins with the identification of a problem.
It also contributes to patient care by classifying nursing phenomena and standardizing language among nurses. Nursing diagnoses are scientific interpretations of data that appeared and that are used to guide planning, implementation, and evaluation of nursing practice. The use of nursing diagnoses gives more visibility to nurses, whose caregiving has previously been invisible or unrecognized(20). Defining characteristics and factors are related to nursing diagnoses. Those characteristics are passible clues of observations and checks.
The Provision of Culturally Safe Nursing Throughout this report the following topics will be discussed. Some of the personal factors affecting communication and nursing care including cultural, religious, ethnic and diversity amongst patients and nurses. In this section important factors in the health care system that could cause problems for patients and their families whilst receiving care from hospitals or other services will be discussed. In conclusion details of some of the implications that culturally safe nursing approach may have on the nursing practice will be covered. Other examples include what is acceptable behaviour for each patient.