Nursing-sensitive indicators are standards and practices used to increase the safety, quality of care, and thus satisfaction of patients. More specifically, these indicators provide nursing staff with the knowledge to identify potential issues and the tools to prevent or reduce the likelihood of negative patient outcomes encountered in the healthcare profession. While these standards of care have been expanded and refined to encompass numerous aspects of nursing, the parallel between nursing quality and positive patient outcomes fuels the continuation of analysis and evaluation of evidence-based intervention and prevention practices. The importance of understanding and evaluating nursing standards, quality of care, safety, and even ethics is …show more content…
J. Some of them included the possibility of a pressure ulcer, use of restraints, error in diet, disregard of health risks and errors, and lack of respect, accountability, and transparency with the patient/family. However, the most serious issue from a medical standpoint was the pressure ulcer. If the nursing staff in this scenario were aware of the nursing-sensitive indicators, the risk of pressure ulcer could have been lowered or even prevented. The nursing staff would have been aware that advanced age, duration of down time or immobility, and even nutrition are risk factors relevant to pressure ulcers in this situation (Cooper, 2013). Mr. J is 72 years old with a broken hip and spending most of his time healing in bed. These care professionals should have been using interventions such as pressure redistribution to alleviate the amount of pressure on the affected area of his back. Additionally, the use of restraints is also a contributing risk factor and can interfere with pressure redistribution intervention. Furthermore, restraints should be used as a last resort. While Mr. J has been diagnosed with mild dementia and is on pain medication, he is coherent and is not agitated. Even if the restraint was a fall-precaution, his daughter was accompanying Mr. J; she could call for help if a situation …show more content…
The NDNQI (National Database of Nursing Quality Indicators) is a comprehensive database that provides healthcare facilities with a host of resources aimed at improving the quality of nursing care and patient outcomes. Specific structure, process, and outcome indicators are measured and evaluated through data submitted by healthcare staff; and appropriate feedback is provided on that data (Montalvo, 2007). A 2013 study demonstrated the effectiveness of nursing-sensitive intervention care on the prevalence of hospital-acquired pressure ulcers. The prevalence of these pressure ulcers was significantly reduced from 21% to a mere 4% in a six month span (Insook, Ihnsook, Eunman, Eunjoon, & Bates, 2013). A study performed in 2015 on the prevalence of restraint use in several hospitals revealed similar findings. When nursing-sensitive indicators education and interventions on restraint use were provided and implemented, respectively, the prevalence of use was reduced from 5.87% to 1.73% (Cosper, Morelock, & Provine, 2015). The reduction rates from each study support the use of nursing-sensitive indicators, as well as the importance of data collection, measurement, and evaluation of these indicators to improve nursing
Safety competency is essential for high-quality care in the medical field. Nurses play an important role in setting the bar for quality healthcare services through patient safety mediation and strategies. The QSEN definition of safety is that it “minimizes risk of harm to patients and providers through both system effectiveness and individual performance.” This papers primary purpose is to review and better understand the importance of safety knowledge, skills, and attitude within nursing education, nursing practice, and nursing research. It will provide essential information that links health care quality to overall patient safety.
Nurses are key components in health care. Their role in today’s healthcare system goes beyond bedside care, making them the last line of defense to prevent negative patient outcomes (Sherwood & Zomorodi, 2014). As part of the interdisciplinary team, nurses have the responsibility to provide the safest care while maintaining quality. In order to meet this two healthcare system demands, the Quality and Safety Education for Nurses (QSEN) project defined six competencies to be used as a framework for future and current nurses (Sherwood & Zomorodi, 2014). These competencies cover all areas of nursing practice: patient-centered care, teamwork and collaboration, evidence-based practice, quality
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
The decision to restrain a patient is in most cases left to the nurses. Other professionals such as occupation therapists and mental health counsellors are not consulted. A research on nurses’ decision-making process on physical restraint outlined that one of the themes associated with nurses decision making is personal thoughts and reason (Goethals, Dierckx de Casterlé and Gastmans, 2011, p.1200). This shows that most of the time nurses restrain the patients without consulting other professionals who might have had a better solution in handling the
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
...l. "[The Use Of Physical Restraints In An Acute Care Hospital]." Assistenza Infermieristica E Ricerca: AIR 23.2 (2004): 68-75. MEDLINE. Web. 22 Oct. 2013.
Providing the steps to ethically sound excellent care, healthcare providers must acknowledge first the legal and ethical matters involved with proper investigation and then devise a plan for best possible action recognizing the rights of the patient and its benefits followed by the application of the chosen intervention with positive outcome in mind (Wells, 2007). Delivery of excellent and quality of care at a constant level (NMC, 2008) must be marked in any responsibilities and duties of the care provider to promote exceptional nursing practice. Codes of nursing ethics and legal legislation have addressed almost all the necessary actions in making decisions in consideration to the best interest of the patient. Nurses must make sure that they are all guided by the set standard to lead their action and produce desirable and ethically sound outcomes.
Association, A. N. (2010). Nursing Scope and Standards of Practice. (2nd ed.) Maryland: American Nurses Association. Retrieved January 20, 2014 from http://media.wix.com/ugd/8c99f2_4fde86431966e34f2e03bbb137edfee3.pdf
O’Daniel, M., & A.H., R. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: Agency for Healthcare Research and Quality. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2637/
In an article written by Samantha P. Ziglar, BSN, RN, she describes the main purpose of restraints through her eyes in the medical field. Ziglar states that at least one in every four patients will be restrained at least once, that’s 79.715 million people in the United States (Population). “Specific reasons include fall prevention, limiting wandering behavior and preventing dislodging or interference of therapeutic devices, and controlling violent or agitated behavior” (Ziglar 1). Ziglar emphasises the growing problem among restraints; improper use among nurses. “Patient safety should be every nurse’s top priority; therefore, nurses need to have a thorough knowledge base of the risks and benefits of using physical restraints” (1). As a result of what a nurse needs, restraints are required to succeed in his or her profession, making their patient as safe and comfortable as possible. The purpose of restraints as a whole is to provide patient protection. Ziglar lists the pros and cons of the use of restraints. Some major
The Scenario for this paper looks at a patient who is currently in the hospital due to a broken hip. He is a retired Rabbi with mild dementia. There are several issues within the scenario that could be addressed but there are three that are acutely noticeable that can be concentrated on and resolved if there is an awareness of nursing sensitive indicators (NSI). These NSI are pressure ulcer and restraint knowledge and staff education.
In October of 1998, the Courant’s survey of the 50 states identified that 142 individuals died in physical restraints or seclusion. Another study was done in four Turkish hospitals from July to September of 2005. The study’s findings were, “Nurses used either wrist, ankle, or whole body restraints at various levels. Those nurses who worked in surgical intensive care units and emergency departments and had in-service training used more physical restraint than did others. Only a third of nurses decided on physical restraint together with physicians and three-fourths tried alternative methods. Nurses reported edema and cyanosis on the wrist and arm regions, pressure ulcers on various regions, and aspiration and breathing difficulties in relation to physical restraint.
Mitchell, P. H. (2008). Defining patient safety and quality care an evidence-based handbook for nurses. Rockville,Maryland: Hughes. DOI: //www.ncbi.nlm.nih.gov/books/NBK2681/
Maintenance and promotion of quality improvement initiatives are essential for the successful growth and development of the health care industry. Nurses are key to all quality improvement initiatives as they are in the frontlines and have the most contact with the healthcare consumers. Therefore, nursing professionals are good at putting in their valuable inputs for quality improvement efforts. On a daily basis nursing professionals strive to deliver safe, efficient, effective, patient-centered care in a timely manner. With the growth and development in the health care industry, there is an increased need to provide competent and high quality services. Nurses are equipped with distinctive proficiency required for delivery of patient care
Nurses should develop a critical thinking skill which includes detecting the problem, choosing the best possible solution and determining the best way to resolve the problem. Critical thinkers made a reflection on the condition after implementing the plan to assess the effectiveness of the plan and if it can be done better (Tweed et al., 2016). This paper will answer the clinical question of “Does repositioning bed ridden patients are more effective in reducing pressure ulcer compared to the use of air