RTT1 Sullivan Task 1

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Nursing Sensitive Indicators
Western Governors University
Yovaletta Sullivan

Nursing Sensitive Indicators
A. Nursing sensitive indicators examine several aspects of nursing care and their relationship on the quality and satisfaction of patient care. They can be related to nursing structure, process, and outcomes and encompass nursing education, nurse job satisfaction, nurse assessment skills, and nursing interventions. These indicators are labeled nurse sensitive because patient care has been noted to improve with an improvement in the quantity and quality of nurses (American Sentinel University, 2011). The scenario provided in this task addresses several indicators including pressure ulcers, restraint prevalence, patient satisfaction, and length of hospital stay. Understanding the direct relationship between nursing sensitive indicators and quality patient care can serve to decrease the occurrence of poor patient outcomes. The complication of pressure ulcers is tied directly to the use of restraints in Mr. J. After assisting Mr. J. to the bathroom, he was returned to bed in the same supine position and restraints re-applied. It is difficult to assess from this situation how long he had gone without a position change and how frequently his restraints were being assessed or released. While the CNA can facilitate repositioning the patient, she is not qualified to assess Mr. J.’s skin condition and intervene accordingly. Her lack of understanding led her to advise Mr. J.’s daughter that the pressure ulcer was “nothing to worry about. Additionally, it is unclear if restraints have been deemed medically necessary. It is possible that they may have been at an earlier time of his hospital stay and should be re-evaluated, especially during the time that family is present at the bedside. A pressure ulcer that is not properly treated can lead to a longer hospital stay for Mr. J. The incident regarding Mr. J’s diet is linked directly to patient satisfaction. Mr. J. does not have control over many of the factors concerning his care however, his ability to choose his meal is important in maintaining a sense of autonomy. Mr. J‘s request for kosher, chopped meat was disregarded resulting in him not completing his meal in its entirety. When the error was discussed it was done so in a disrespectful and dismissive manner; no assurance was made that future meals would be kosher as requested. Judging by the dietary and nursing staff’s attitudes, it is possible that had not Mr. J’s daughter filed a formal complaint, the meat served may have continued to not be kosher and Mr. J. would miss a significant amount of protein in his diet. Adequate nutrition is essential to his healing process. The formal complaint made to the physician revealed that this situation is not unique to Mr. J. It is reasonable that the physician may choose an alternate hospital to care for his Jewish patients. B. Gathering and analyzing data on the incidence of pressure ulcers and restraint use aids to help identify concerns, illicit change, and track those changes over time. Specific data on restraints can depict when restraints are overused, under used, and if they are used properly according to hospital policy. Data pertaining to the incidence of pressure ulcers can be further examined to determine contributing factors (Agency for Healthcare Research and Quality). Contributing factors may include mobility and number of appropriate staff. Acquiring hospital data can help determine if there is a direct correlation between nurse sensitive indicators and the area of concern. For example, data may show an inverse relationship between the number of nursing staff available and the prevalence of restraint use. It is reasonable to assume that a decrease number of nursing staff could result in an increase in restraint use. Analyzing this data can promote quality patient care because it is beneficial to see a direct cause and effect relationship....
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