Organizational Systems & Quality Leadership: National Quality Initiatives

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Nursing-sensitive indicators refer to the processes, outcomes, and structures that are applied in nursing in order to provide quality nursing care to patients. The nursing care structures are dependent on whether there are adequate and potential nursing staff and the level of qualification of the staff. The indicators of the nursing processes are determined intervention measures that are applied by the nursing staff, assessment, and a measure of how the nursing staff satisfies their clients. Patient outcomes that are meant to be nursing sensitive are those aspects in patients that improve as a result of the provision of quality and quantity nursing care such as patient falls, urinary tract infection, and pressure ulcers (Roux, G. & Halstead, 2008). Nevertheless, all patient outcomes are not termed as nursing-sensitive; this is due to the institutional-based care which is determined by the policies and the medical care of an institution. This paper will assess how the understanding of nursing-sensitive indicators can help improve the situation of Mr. J who has been diagnosed with mild dementia.

Understanding of nursing-sensitive indicators

There are well-defined principles and guidelines which determine the role of nursing. These principles and guidelines are meant to provide a way in which nursing can determine and make improvements and evaluation of its role in order to ensure that its practices are geared towards the delivery of quality health care. In order to achieve the objectives of delivering quality health care; nurses are guided by the code of ethics to promote, strive and advocate to ensure that, the health, rights, and patients safety are strictly observed (American Nurses Association, 2001). The nursing-sensitive indicators help to aid the nurses in the provision of patient safety, provision of improvement efforts, and general care for the patient. By understanding this, the certified nursing assistant should have recognized that Mr. J required immediate attention to go to the bathroom instead of waiting for the daughter to come and assist. Mr. Js scenario indicates that he did not receive quantity and quality attention from the kitchen; this is because even his diet order was not taken into consideration. If the guidelines of the nursing-sensitive indicator were to be observed; Mr. J should have been provided with a diet that he ordered, his hygiene observed and this would aid his fast healing.

Analysis of hospital data

A database of nursing-sensitive indicators is important in that it helps the nursing managers to evaluate the work performance of the staff and this can aid in nursing retention and facilitate the recruitment of more efforts (Rantz, 1995). The database of indicators is established on feasibility tests and should incorporate the measures that should be taken in order to provide good outcomes in terms of nursing care. For instance, an indicator like the nursing hour per patient can have sub-indicators like the number of registered nurses, vocational nurses, and the unlicensed assistive personnel available; this is a good measure of the hospital structure (Hart et al., 2006).

The data concerning the nursing-sensitive indicators can also help to improve the health care of a patient because such data have been used in the hospital in implementing pilot testing. Such data is important because it is used for continuous monitoring and the test for the validity of the indicator (Hart et al., 2006). Mr. Js scenario could be solved easily as the certified assistant nurse told the patients daughter; this is because the nurse could employ the data about ulcers and restraints in the hospital database to address the problem.

The data of the number of hospital beds is important in that it provides enough information that the beds are not adequate. The hospital beds are 65 and the Jewish members travel 20 miles away to receive medical care. The is therefore need for the establishment of a hospital in the Jewish community in order to cater for such cases as emergency patient falls and other indicators like pressure ulcers which require prompt medical attention.

Analysis of system resources, referrals, and colleagues

The hospital resources, referrals, and the nursing staff can improve the nursing care of Mr. J. through sharing the best practices. The facilities that are marked to have made improvements in nursing-sensitive indicators should share the practice that they employed with other facilities in the hospital. The certified nursing assistant exercised best practices by helping Mr. J to go to the bathroom and later returned him on the bed to reapply restraints. The cooking facility of the hospital failed to exercise nursing-sensitive indicator by serving Mr. J with regular, kosher, chopped meat and instead served him regular, chopped meat. When informed, the kitchen supervisor ignored the error, even the hospital physician complained that the hospitalized Jewish patients complained of their dietary concern that was not obeyed. The nursing supervisor should facilitate sharing of best practices. The certified nursing assistant should be instructed to help the catering facility to improve the facility by instructing the cooks and the kitchen supervisor to obey the diet orders of the patients.

References

American Nurses Association. (2001). Code of ethics for nurses with interpretative statements. Washington, DC: American Nurses Publishing.

Hart, S., Berquist, S., Gajewski, B., & Dunton, N. (2006). Reliability testing of the National Database of Nursing Quality Indicators pressure ulcer indicator. New York: Springer Publishing Company. Journal of Nursing Care Quality. 21 (3): 256-265.

Rantz, M. (1995). Nursing quality measurement: A review of nursing studies. Washington, DC: American Nurses Publishing.

Roux, G. & Halstead. J.A. (2008). Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow. New York: Jones and Bartlett Publishers.

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