Nursing-Sensitive Indicators and Outcomes

Nursing-Sensitive Indicators and Outcomes

Western Governors University

Nursing-Sensitive Indicators and Outcomes

Understanding of Nursing-Sensitive Indicators

In this specific scenario it would be important for the nurses to have a full understanding of the nursing-sensitive indicators that were involved with this patients nursing care and overall outcome. Being aware of pressure ulcer prevention measures and applying to the nursing practice is imperative for optimal patient outcomes. The nursing care in this scenario did not portray the understanding or concern required to provide this patient with the best outcome of preventing a pressure ulcer. When noticing a severely reddened area of skin it would be necessary to have the knowledge not to ignore it and place patient back in the same position in bed that most likely created the sore area on back. The nursing practice in this scenario should have consisted of a knowledge base that would make them aware of a nursing-sensitive indicator such as pressure ulcers, and be able to easily identify the care necessary for this patient. The nursing staff would ideally recognize the pressure ulcer on this patient and be aware of how imperative nursing care is specifically, in this scenario in preventing a worsening outcome for this patient.

The understanding of nursing-sensitive indicators such as use of restraints would also be helpful in assisting the nursing care in this scenario to recognize their role in assessing how often restraints need to be used and limiting use when possible. In this scenario it was not shown to be necessary to keep this patient in restraints when he had family in room, especially when the restraints were proving to keep patient in a position that was creating a pressure ulcer on his back. The awareness of a nursing-sensitive indicator would have assisted nursing staff to improve assessment skills of the use of the restraints and could have limited the amount of time this patient needed them. Nursing practice should reflect this understanding, which ultimately affects patient outcome.

It is highly important that nurses remember how big of an impact their nursing care can have on patient’s outcome. The nursing–sensitive indicators are the specific areas that nurse’s have direct control of to have an influence on the patient outcome. With this in mind the nurses in this scenario would also be able to increase patient satisfaction by understanding what aspects they can play a role in with gaining the best experience for the patient and family. The nurse could have had a more appropriate response and understanding of culturally sensitive issues regarding the patient’s food preference. Although mistakes happen, the insensitive response given by the nurse to the patient’s daughter was not portraying any concern or remorse. If I were the family member in this scenario I would be concerned that their lack of concern would imply this can easily happen again, and that there was not full respect being shown to my father.

Hospital Data on Specific-Nursing Indicators

It is important that hospitals are able to acquire specific data about nursing-sensitive indicators, and how they influence the quality of outcomes. This research can provide a better understanding for nurses to know why specific nursing care is necessary to gain the outcomes that we should always want to achieve. Being able to see how certain factors of the nursing practice can have a strong correlation with outcomes throughout the hospital is enlightening and often the incentive needed to guide change. Data that is specific to each unit in a hospital is also an important aspect when evaluating these nursing-sensitive indicators most affectively. When hospitals share their data with other facilities it can help other nurses learn from it. This knowledge can be spread so that more nurses can utilize the strategies that enhance patient care.

Hospital data related to a specific nursing-sensitive indicator such as pressure ulcers can provide information on how certain preventative measures can make an impact on the outcome of the patient. By seeing the research data from a hospital that put a process change into affect in regards to pressure ulcer preventative measures, the positive outcomes can show nursing how their specific care can make a difference. This kind of data can help support the hospitals decision to implement the changes in the nursing care that provide the best quality of care. As a professional nurse it should always be a priority and ethical responsibility to do everything possible to improve the quality of nursing practice.

Ethical Issue Resolution of Scenario

The ethical issue in this scenario that requires resolving involves the patient and his daughter. The patient is Jewish and requested a kosher meal, but did not receive the correct tray and consumed a regular meal tray that was not kosher. When the daughter was made aware of this mistake the nurse did not have a sensitive or apologetic response when asked about it. The daughter notified the physician and it was then brought to the hospital administrator’s attention.

In this scenario it would have been important to resolve the issues the day that it happened instead of keeping the mistake from the patient and family, and waiting for them to find out the way they did. That dishonest approach, along with the nurse’s insensitive acknowledgement of the mistake is what escalated the issue. The nursing supervisor on shift could attempt to resolve this issue by stepping in and communicating to daughter what exactly had happened and providing a sincere apology. She should also notify the management of the department so that they can decide and possibly designate a representative to handle the communication required to resolve this event with the patient, family or physician. If the hospital has staff that specifically deals with patient advocacy and concerns, then that person should be contacted so that the family feels their concerns are being taken seriously and steps are being taken to help resolve the issue at the time and for the future.

According to the scenario the physician feels that this is an ongoing issue with the kitchen. It would be important that management in the kitchen is properly notified and made aware of the significance of these mistakes. This can promote necessary change in the way things are done to prevent these mistakes in the kitchen. Requesting a kosher meal may not be common for this hospital, but that does not mean it shouldn’t be treated with the same respect that any other dietary request is given. This event may alert management to provide better education to their staff in regards to being culturally sensitive to all patients and treating their requests with respect even if they are not personally understood. The nurse in this scenario that chose to initially hide this mistake from the patient and the one the next day that did not take the family’s concern seriously, both should hear what impact their decisions had. The nurses should also be given a chance to provide feedback about their perspective on their actions. The mistake was not what made this an ethical issue; it was the way the nurses chose to handle it that enhanced the mistake into an ethical issue as well.

References:

Cherry, B. (2014). Contemporary Nursing Issues, Trends, & Management 6th Ed.

Retrieved from: https://wgu.vitalsource.com

Institute for Healthcare Improvement. (2017). Quality Improvement: 
IHI Open School (Q1 103).

Retrieved from: www.ihi.org