Understanding of Nursing Quality Indicators

A. Understanding of Nursing Quality Indicators

Nursing quality indicators are important because they drive the care of the patient given by the nursing staff. When discussing the issues with this scenario, the list is long and each issue is important. It is first mentioned that Mr. J’s daughter “found him in restraints.” This implies that she was not informed about the application of the restraints and how his condition had changed to require their use. Staff should be educated that it is appropriate to inform the family when a patient’s medical status changes, requiring restraints to maintain the patient’s safety. As he was taken to the restroom, it is noted that there is a redness to his back, giving the impression that he has been laying on his back for an extended period and not turned frequently enough to remove the pressure from his sacrum. Insuring that the patient is turned every two hours helps to reduce the incidence of pressure ulcers and should be reinforced to staff. In an effort to decrease the instances of pressure ulcers, a safety huddle at the beginning of each shift could go over which patients are at increased risk for pressure ulcers and should be assessed for pressure ulcers and turned every two hours. Data could be gathered and evaluated to discover if policy changes should be addressed. Depending on what the information shows, the manager and staff could collect recommendations for practice changes and implement them to evaluate if the changes are successful.

B. Quality Improvement for Patient Care

Using hospital specific data can advance quality patient care because it can show areas in which that specific organization needs to improve. Each organization should have a Quality Improvement department to collect and track patient outcomes such as nosocomial infections and pressure ulcers. Each unit is evaluated separately on different nursing quality indicators, such as restraint use and patient falls, then the data is reported to the Quality Improvement Department. In the instance of restraints, the data to be gathered would be the amount of time in the restraints, skin assessment every two hours as well as the intervention taken when there was breakdown present. Information on falls would be repeat falling patients, injury that occurred and if the patient was on high-risk medications. The collection of information would be shared with the nursing staff. If there is an increase in falls or skin breakdown, the practice policies and procedures would need to be reevaluated to reverse these incidence as well as reeducating the staff as to why they would need to be proactive on the behalf of the patient.

C. Resolving the Ethical Issues

As a nursing shift supervisor, the first step I would take would be to apologize to the patient and daughter for the mistaken