Wgu Paper

Part A

It is quite evident that there was a lack of understanding of several key nursing-sensitive indicators in the case of Mr. J. The nurses would benefit from following the nursing standards set by the IOM, the National Academy of Sciences Institute of Medicine. According the IOM, care must be safe, equitable, and patient centered (IOM, 2001). In the case of Mr. J, the nursing staff failed to provide safe care in that he was left alone restrained and had developed a pressure ulcer on his back. The care was neither equitable nor patient centered in that they did not respect his Kosher diet and did not take the concerns of his daughter seriously.

The American Nurses Association has established the National Database of Nursing Quality Indicators and several of these occurred in this case including: pressure ulcers, restraint prevalence, and patient satisfaction (ANA, 2012). Had the nursing staff understood key indicators, the care of Mr J received would have been quite different. The nurse and CNA would have known that the red spot on his back was a pressure ulcer and that he needed to be repositioned, instead of putting him back to bed on his back. And the fact that the patient could ask for help to go to the bathroom should have indicated to the nurse and CNA that he may no longer need to be restrained, if he even needed to be restrained at all in the first place. Had the nurse realized that restraint prevalance is a significant nursing-sensitive indicator, she would have considered the use of a bed alarm or patient safety attendant before restraining the patient. If patient satisfaction was taken into consideration, the nurse would not have dismissed the meal tray error and would not have make the disrespectful remark to the daughter when she asked about it. The nurse could have notified the family sooner of the incident and apologized for the error.

Part B

Hospital data on specific nursing-sensitive indicators could advance quality patient care throughout this hospital by raising awareness of issues specific to the hospital. The Model for Improvement could be utilized in this case if data were to be collected. The second step in the Model for Improvement asks about measures: "how will we know a change is an improvement?" (IHI, 2015). By collecting data on indicators such as pressure ulcers, restraint prevalence, and patient satisfaction, the staff would be able to then track their progress over time and implement interventions for improvement. For example, if the hospital found that they had 5 hospital-acquired pressure ulcers in the month of May, the nurses could work together to ensure all patients are repositioned at least every two hours. If the number of pressure ulcers decreases over time, then it would indicate that their intervention improved patient care. The nurses could also track restraint prevalence per