C489 Task 1 Organizational Systems and Quality Leadership PDF

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Nurse Quality Indicators...

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Running head: Organizational Systems Task 1

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Organizational Systems and Quality Leadership Task 1 Western Governors University July 10, 2020

Updated 02/12/19

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Organizational Systems and Quality Leadership Task 1

Understanding of Nursing Quality Indicators The term "nursing-sensitive indicators" originated in 1996 by a group of researchers to indicate features of patient care primarily influenced by the way nurses attend to their patients. Structure, process, and outcomes of nursing care are the three attributes demonstrated in nursingsensitive indicators (The Sentinel Watch, 2011). These indicators are distinct to nursing and affected by the care nurses provide. Individuals that commit to the nursing profession do not do it for the money. They invest their time in nursing because they want to be the person that makes a difference in someone's life. In the synopsis provided, the standards of care, and oversight of possible tissue damage resulting from not being turned due to physical restraints come into question by Mr. J's daughter. The daughter pointed out the redness to the certified nursing assistant who did not give the impression of being alarmed by the looks of Mr. J's skin and appeared to disregard the daughter's comments. Pressure ulcers or skin breakdown is extremely avoidable. Repositioning of a patient is to occur every two hours when bedbound. The nurse should discover the redness during the physical assessment as well. In utilizing nursing-sensitive indicators, personnel will recognize the importance of notifying the appropriate individual regarding important matters with patient care. In following these guidelines, the staff avoids adverse outcomes, and the quality of patient care improves. Given the scenario, Mr. J, even with pain medication administered, can answer easy questions correctly. As for the restraints, Mr. J's dementia is not advanced, and alternate measures are applicable in this situation. Suitable options in place of physical restraints are the use of bed alarms, a room near the nurses' station, or a sitter in the room. Physical restraints are

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a last resort, primarily when the patient is oriented, and family members are present. The reason for Mr. J experiencing a fall, which is the reason for his admission, should come into question (does he take pain medication at home, does he experience episodes of dizziness-possible inner ear issues, etc.). Pain management is a top priority at present due to his hip fracture. Evaluate Mr. J's pain and pain medications to determine if there is a need for narcotics, can a lower dose be given, or change drugs to non-narcotic formula. Patient satisfaction is a number one priority, and nursing sensitive indicators can provide instruction in assisting to identify difficulties to prevent negative results and enhance the quality of care provided. Advancing Quality Patient Care Within the scenario, the nursing quality indicators that attract attention are Mr. J's recent fall resulting in breaking his hip, his pain, the use of restraints, and the likelihood of a developing pressure ulcer. The institution should use this data to compare, analyze, and trend to initiate corrective measures and record any advancement or regression with patient care and patient satisfaction. Formulate additional ways to track and trend data with nursing sensitive indicators to strengthen and maintain patient quality of care and patient satisfaction. The organization should consider staff contentment in regards to staffing numbers (including support staff), supply availability, and hours worked during a week or shift, which allows for overall job satisfaction and the ability and motivation to care for patients to the best of their ability. Resolution of Ethical Issues An ethical issue within the scenario is the patient receiving an incorrect dietary order. According to the synopsis, Mr. J is Jewish, and his diet order specified "regular, kosher, chopped meat," and Mr. J received a meal labeled "regular, chopped meat" consisting of pork. In addition to the incorrect meal, no one notified the family of the error until the next night when the dietary

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worker apologized for the mistake. The apology triggered the daughter to question and report the event to the physician, who, in turn, informed the mishap to the hospital administrator that this was not the first incident of this kind. This mishap gives the impression of being a frequently happening circumstance. Corrective measures for the event begin with the nursing supervisor. The nursing supervisor and dietary manager should hold a meeting to ascertain and develop action plans to provide correct meal orders according to patient requests and strategies to avert further mistakes. Social workers are in-house resources to guide and educate in terms of diet choices and limitations regarding religion or health conditions. Another in-house resource to consult is the hospital clergy. The clergy may provide necessary or helpful information regarding religious dietary needs. The dietary manager of the Jewish Hospital, which is nearby, would be an exterior resource to aid in the development of an action plan. The Jewish Hospital may share its specialty menu for assistance in averting misfortunate events with incorrect meals served to patients. The hospital could use the Jewish hospital's menu or compose a listing of foods all their own.

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Running head: Organizational Systems Task 1

References The Sentinel Watch. (November 2, 2011). The 3 types of nursing sensitive indicators. Retrieved from https://www.americansentinel.edu/blog/2011/11/02/what-are-nursingSensitive-quality-indicators-anyway

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