Monitoring for early recognition of adverse events, errors, and complications and initiating notification to the appropriate care provider for timely interventions are essential nursing functions that can have a significant effect on patient safety, quality of care, and resulting outcomes. Nursing sensitive patient outcomes are those that improve with greater quantity and better quality nursing care. (Cherry & Jacob, 2011) In the given scenario it is clear that that both, the nurse and the certified nursing assistant (CNA) need to have a better understanding of nursing sensitive indicators as well as the hospital’s policy and procedures. Failure to identify the nursing-sensitive indicators resulted in unnecessary use of restraints, development of pressure ulcer, and patient dissatisfaction with care. The use of restraints for Mr. J was an inappropriate action as he was not a danger to himself or others.
Nursing-sensitive indicators represent nursing’s contributions to patient care. Nursing-sensitive indicators represent nursing’s contributions to patient care. RTT1 Task 1 RTT1 Task 1 Nursing-sensitive indicators reflect the structure, process and outcomes of nursing care (American Nurses Association, Inc., 2014). Patient outcomes that are determined to be nursing sensitive are those that improve if there is a greater quantity or quality of nursing care (American Nurses Association, Inc., 2014). One nursing-sensitive indicator is the development of pressure ulcers.
Nursing sensitive indicators are by definition,” elements of patient care that are directly affected by 2 nursing practice.”(American Sentinel University - Healthcare, 2011, para. 1) These elements can be further broken down into: Structure - This includes staffing levels, staffing mix, staff education level and the staff experience level. Processes – This includes methods of assessment, methods of care, and types of interventions. Outcomes – these are directly related to quality and quantity of nursing care. With the given scenario, many nursing specific indicators could have been observed to significantly improve Mr. J’s hospital experience.
These areas are patient satisfaction, pressure ulcers, patient falls, job satisfaction of nurses, hospital acquired infections, time of nursing care allotted for each patient, and staffing ratio/mix. By identifying any deficits in such areas of patient care hospitals and its staff can be proactive in making any necessary changes to improve both patient outcomes and staff satisfaction ("What are Nursing Sensitive Quality Indicators Anyway?," 2011). In the scenario with Mr. J there were numerous nursing-sensitive indicators that were red flags. By being aware of such “red flags” corrective action could have been taken to provide better quality of care to the patient. The nursing-sensitive indicators can be categorized in the following ways: 1) Patient falls: Mr. J was a fall risk due to his mild dementia, age and recent history of a fall at home.
Nursing Sensitive Indicators and Patient Care An analysis of the following nursing quality indicators should be deliberated: * Nursing hours per day * Unlicensed assistive personnel (UAP) hours per day * Pressure ulcer rates * Restraint use * Nursing and UAP education Pressure ulcer rates for the hospital and the unit – Review policy on pressure ulcer prevention education for UAP. Does the hospital need more education on pressure ulcer development and what to look for? An adequate understanding of the Braden scale along with making early communication between the RN and the UAP a priority, improves patient outcomes (Howe, 2008). Could an increase in RN presence prevent further skin breakdown? RNs can provide greater direct assessment of potential wounds.
Acute care looks at the patients’ symptoms, test results and diagnosis along with evidence based practice to make a care and treatment plan to restore patients function. The RN may be specialized to work in certain areas of care that require experience and knowledge. The RN responsibility in acute care is to manage pain, coordinate patient care, minimize infection, and improve hospital discharge to prevent readmission in raising cost to the hospital and insurance companies. (www.inqri.org) Prevention, detection and available resources about illness are important education topics the RN teaches the patients and family members when in the acute setting. With poor prognosis of chronic disease acute care may not get the results needed for a patient to get back to baseline so they become reliant of medical professionals and nurses for care.
Assessment Tool Analysis Paper Assessment tools are used to evaluate and help with the intervention of a patient’s physical, mental, and emotional well-being. They enable medical practitioners to help the vulnerable make informed and appropriate choices for a normal life. Assessment tools can be useful in improving family dynamics, building more cohesive relationships, and promoting healthier lifestyles. There are many different types of assessment tools, some are more effective than others and it is the responsibility of the practitioner to determine the tool that best fits the dynamics of their patient's particular situation. Jean Watson is recognized for her theories on human caring and the way nurses give care.
Assessment is a systematic process using a rational method of planning to identify a patient’s health and any actual or potential problems that need to be met and to provide interventions to meet those needs. (Berman et al, 2010) A comprehensive assessment establishes a database of information relating to the patient including visual observations during initial interview including, skin condition, cloths, hair, hygiene, demeanor and presence of pain etc. During the interview the nurse should gather family history and both subjective and objective data to establish baseline data as a reference point and an indicator to the effectiveness of interventions. (Berman et al, 2010) Subjective data is what the patient thinks, feels and believes and can also be referred to as the symptoms including itching, pain and worry or anxiety. Objective data is measured during the physical examination; it can be seen, heard, smelt, felt, observed, tested or measured against an excepted standard, including: skin color, bowel sounds, blood pressure, temperature, level of pain, urine analysis etc.
“These are: peson, environment, health/illness, and nursing put forward by the American Nurses Association. Nursing is the protection, promotion and optimization of health and abilities, describes the metaparadigm of environment. This is described by our textbook as the internal factorsaffecting the client and the setting where nursing care is delivered. It also refers to the surroundings of the client. Prevention of illness and injury, refers to metaparadigm of health and illness, which describes the client’s state of well-being.
The quality of care would be monitored by a series of inspections in health settings such as care homes, hospitals, GP surgeries and many other health organisations. The responsibility of the Care Quality Commission is to recognise where effective care is being carried out and the areas in which improvements can be made. This would be a continuous cycle that changes according to whether relevant laws are put into place and the experiences of service users. The CQC set a standard of quality and safety that service users should expect when receiving care off health organisations. The standards of quality and safety would change according to the health care providers roles due to them providing different cares e.g.