Placing patients close to nurse’s station or offering frequent toileting can also help reduce potential injuries. If falls continue to occur with precautions in place, incidents need to be reviewed to identify where improvements can be made. Educational opportunities can be offered to staff on the importance of enforcing fall precautions on at-risk patients. Many different nursing-sensitive indicators can be tracked in the same fashion. The important element here is to continuously monitor standardized performance measures and assess the extent to which nursing interventions have an impact on patient safety, quality, and the work
Nursing sensitive indicators reflect the structure, process and outcomes of nursing care. The structure of nursing care is indicated by the supply of nursing staff, the skill level of the nursing staff, and the education/certification of nursing staff. 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) Knowledge of these indicators could have assisted the nurses in several ways involving this case.
RTT Task 1 WGU Organizational Systems and Quality Leadership RTT1 May 28, 2015 RTT Task 1 - Nursing-sensitive Indicators A. Nursing-Sensitive Indicators In the scenario presented, Mr. J is an elderly Jewish male with mild dementia. He is hospitalized due to a right hip fracture following a fall in his home. He has religious and cultural preferences that affect his diet. This scenario contains nursing-sensitive indicators that include patient falls, restraint use, pressure ulcers and patient satisfaction. Nurses need to be educated on these indicators to understand the care they provide directly affects patient outcomes.
Western Governors University RTT1, Task 1 The following essay will identify how nursing-sensitive indicators could improve the care of Mr. J. The paragraphs below will discuss how application and tracking of these indicators can be beneficial to the overall care provided at the hospital. In addition, there will be discussion of how the lead nursing supervisor can use the identified principles to resolve ethical issues in care. A. Nursing-Sensitive Indicators Nursing-sensitive indicators were developed by the American Nurses’ Association (ANA) to reflect the structure, process and outcome of nursing care. Structure is measured by the staff: amount, skill-level, and education or certification.
Indicators of structure are measures by the supply and skill level of nursing staff as well and the education and certifications of the nursing staff. Indicators of the nursing process are nursing assessments, interventions 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 (e.g., pressure ulcers, falls, and intravenous infiltrations). (American Nurses Association, 2014) NDNQI: National Database of Nursing Quality Indicators. There are some patient quality and safety measures which have been shown through research to be significantly affected by nursing care or “nurse-sensitive” measures.
In relation to nursing, the team leader may be designated by a job title, such as charge nurse. Understandably, there may be more than one team leader for different shifts with those shifts working as a team. Being an effective team leader is not the same as being a competent nurse. As nurses, we are educated to provide clinical care within our scope of practice. Through experience, we develop our skills and knowledge.
Nursing indicators such as education on unnecessary use of restraints and not repositioning the patient every two hours, are failures to deliver quality care. The staff increased the chances of Mr. J to develop pressure ulcers. Also the use of restraints increased the chances of Mr. J to develop a deep vein thrombosis or pneumonia from lack of mobility. All members of the healthcare team are responsible to provide the best care possible and be an advocate for the people they care for. (American Nurses Association, 2015).
Nursing Sensitive Indicators Nurse sensitive indicators included in this case are Mr. J’s use of restraints, complications of pressure ulcers, and patient satisfaction. Had the nurse who was caring for Mr. J been aware about the risks of pressure ulcer development with the use of restraints, the beginning stage of a pressure ulcer could have been prevented. Better RN assessment of Mr. J’s restraints, repositioning Mr. J every two hours and a thorough skin assessment should be done at every shift. The NA should be instructed to notify RN if they see anything out of the ordinary with patients, such as the redness to the lower spine of Mr. J. The nursing staff assigned to Mr. J will need additional training about restraints as far as appropriate use of restraints and how to care for a patient who is restrained.
MEMO From: Joshua A. Burger (Gibbs), Phlebotomist, Genesys Regional Medical Center To: Office of Susan K. Kolka, Hospital Administrator, Genesys Regional Medical Center Subject: Excessive needlestick complaints and proposed corrective action 11/11/2009 Introduction Statement of Problem Inpatients of Genesys Regional Medical Center are complaining of excessive needlesticks during their stay at our facility. After receiving dozens of complaints, policy changes were made to allow the patients to receive a heparin lock as standard procedure, but the complaints continued. To promote patient comfort, safety, and well being, the hospital needs to take immediate action to reduce the number of needlesticks that our patients must endure
The nurse would use the 0.05mg/kg IV dose of Morphine, and reassess her pain afterwards. If her pain was not relieved, as evidenced by the FLACC scale, she could then give her another dose of the 0.05mg/kg Morphine. The only way to tell if this choice of pain management was successful would be to keep reassessing her with the FLACC scale. If the number kept decreasing with each assessment, her pain would be improving. It is important to keep her comfortable, but it is also important to give only enough medication to do so.