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Task 1

Name Western Governors University Organizational Systems and Quality Leadership Instructor April 29, 2021

2 Task 1 Nursing Quality Indicators The NDNQI (National Database of Nursing Quality Indicators) was created by the American Nurses Association in 1998 to collect data related to factors that influence the quality of nursing care (Montalvo, 2007). There are fourteen indicators including falls, restraints and pressure ulcers. It is likely Mr. J’s dementia led to impulsivity with getting out of bed unassisted, causing him to classify as a high fall risk patient and leading the nursing staff to apply restraints for his safety. Applying nursing quality indicators could have allowed the nurse of Mr. J to assess for skin breakdown related to being restrained and assist him with repositioning every 2 hours to alleviate pressure. Had these indicators been identified, Mr. J could have had better quality care and a better patient outcome. Advance Quality Patient Care The hospital could advance quality patient care by analyzing data pertaining to the number of falls and incidences of pressure ulcers related to the use of restraints. Education could be offered on appropriate assessment and care of patients who are restrained. Alternate measures could be used in place of restraints for high fall risk patients such as bed alarms, bedside sitters, or camera monitoring systems that allow for a visual of the patient when they are alone in their room. After implementing these changes to the nursing quality indicators, the hospital could analyze the new data to determine if the number of falls and incidences of pressure ulcers has decreased. Analyze specific system resources, referrals, or colleagues to resolve an ethical issue Mr. J had a diet order of “regular, kosher, chopped meat,” verifying that his diet was in the system correctly but was prepared and delivered by staff incorrectly. There were clear

3 failures of communication as evidenced by a supervisor telling the nurse to “just keep it quiet” and the nurse telling the daughter “half a pork cutlet never killed anyone.” As the nursing supervisor managing this ethical issue, I would hold a staff meeting that would include education on patient preferences relating to religion or culture. I would have a discussion with the kitchen supervisor and include a hospital dietician to ensure patient’s dietary wishes are respected. I would also suggest having the dietary aides check the trays after they’ve been completed but prior to delivery to ensure the food selection is appropriate for the patient and matches the diet order. A physician voiced concern over the number of complaints pertaining to the diet orders of Jewish patients, and these changes in preparation, communication and delivery could prevent ethical misunderstandings in the future.

4 References

Montalvo, I. (2007, September 30). The National Database of Nursing Quality Indicators® (NDNQI®). Retrieved April 28, 2021 from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJI N/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.aspx....