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Ethical principles of nursing practice
Ethical principles of nursing practice
Ethical principles of nursing practice
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Organizational Systems and Quality Leadership Task 1
A. Nursing Sensitive Indicators
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.
Starting with the pressure ulcer concern; it is the knowledge of how to assess the risks and create a plan of care to reduce the risk that is being missed and in fact is exacerbated by the restraints that are in place. It is
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We are considering the safety of the patient and restraints don’t necessarily indicate safety. In truth restraints, have been shown to be less safe in many circumstances and the knowledge of NSI in this case would lead to a change in patient care. The need for this change is clearly communicated in an article written by Cotter, V. and Evans, L (n.d.) and they state why restrains in patients with dementia need to be avoided by saying “Use of physical restraints in older adults is associated with poor outcomes: functional decline, decreased peripheral circulation, cardiovascular stress, incontinence, muscle atrophy, pressure ulcers, infections, agitation, social isolation, psychiatric morbidity, serious injuries, and death”. This awareness will lead to an outcome change for this …show more content…
Quality Patient Care
Much of the data used in hospitals today is gathered by patient survey, staff survey or research projects that have been undertaken because of specific incidents that have occurred like, an increase in patient falls etc. Patient surveys can reflect the patients’ needs and show what they feel is lacking in the care giving process and staff surveys can illicit knowledge surrounding clinical issues
Hospital data on specific NSI impacts the outcomes of care within the whole institution. Being aware of the data regarding the prevalence of a problem can lead to resolution or at the very least minimizing the risk factors. For example, if the data shows that infection levels with Foley catheter insertion have increased, then that knowledge should lead to new guidelines to decrease this incidence. The data demonstrating this change, if showing a decrease in incidence, is a reflection of the effect that competent nursing care can have on the outcome
Having data leads to an increase in education for staff because the data will show the training needs. Data will also “reflect the quality of care, Sauls, K (2013); showing quality both in nursing but also within the entire health service allowing for direction in determinations for guidelines, procedures and policy
This study investigated whether the risk assessment strategy, organized versus clinical judgment, impacts pressure ulcer prevalence or prevention procedures. Both Norway and Ireland were picked, Norway has constrained utilization of formal organized risk assessment and Ireland has routine utilization of formal structured risk assessment are two medicinal services setting. They chose one clinical destination, within each of these two countries, as centres for research investigating the utilization and effect of formal organized pressure ulcer risk assessment. As a result, the main point of this study was to decide the distinction in utilizing formal organized risk assessment in the republic of Ireland and clinical judgment alone in Norway.
An organization should retrain their nurses and staff in the importance of quality- data. Patient safety is the most important aspect in a health care facility; if data error is made then the result can be serious, case in point with the second example of this scenario. Some problem with poor quality-data: miss communication, incorrect patient records, causing danger to the patient or even death.
As defined by the American of Nurses Association (ANA, 2002), “Nursing-Sensitive Indicators are those indicators that capture care or its outcomes most affected by nursing care.” The ANA uses the National Database of Nursing Quality Indicators (NDNQI) to statistically test the relationships between nursing interventions, staffing levels, and positive patient outcomes (Nursing Quality - NDNQI, 2016). These indicators utilize unit specific data enabling action planning and intervention according to the unit if improvement is needed (Nursing Quality – NDNQI, 2016). The purpose of this paper is to show how Good Samaritan Medical Center’s 5th floor, pavilion 2, Medical Surgical/Oncology unit uses nurse sensitive indicators such as pain management,
We all know someone who has been placed in a health care setting such as a rest home or hospital because their needed care is out of their families own ability; whether it’s our own grandma or the neighbor’s great aunt. Many people in this day and age are getting care from health care workers on a daily basis and need constant watch and care. Many of those in the older population are put into rest homes where they can spend the rest of their lives in comfort, while others are placed in hospitals to recover from a stroke or a mental illness. At times, many patients become abusive or unresponsive by choice or not. Because of this abuse and also less control over thoughts and feeling restraints are used to keep them safe. Many believe that last statement; that they are completely safe. With my knowledge, the use of physical and chemical restraints in geriatric health care settings, such as rest homes, should be lessened because they cause injury, require patients to need more care and they take away necessary freedoms.
In 2001, over 450 million people worldwide suffered from mental illness (World Health Organisation, 2001) and these numbers have increased by a wide margin since then. Using restraints in treatment for those who are mentally ill is a topic that creates a large amount of controversy. Many are concerned with how the use of restraints can affect the person and if they are necessary or if alternative measures could be used. The National Alliance of Mental Illness has indicated their position on restraints, “The use of involuntary mechanical or human restraints or involuntary seclusion is only justified as an emergency safety measure in response to imminent danger to a patient or others.” (The National Alliance of Mental Illness, 2001) There have
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.
In fact, it is important to the patient’s healing. Before a patient comes to my floor, I look up their history and reasons for admission. This is the gathering or pre-orientation phase. The orientation phase for the bedside nurse would be when the patient arrives on the floor. The nurse introduces their self to the patient and begins establishing trust. The nurse asks the patient questions to see what their expectations are and clarifies the expectations of the hospital or unit. The nurse then explains the plan of care to the patient and answers any questions. In the working phase, the nurse is the patient’s advocate and addresses any problems the patient has. The nurse assures the patient they will research any problems and find out the answers as quickly as possible. Once the nurse finds the answers, he/she relays the information to the patient and the family. He/she may give the patient educational materials, show them a video or simply provide an explanation from the provider. During the resolution phase, the nurse provides discharge information. He/she answers any questions related to discharge and provides the patient with instructions post discharge from the hospital. If the nurse has established a relationship and trust with the patient, the hospital stay and discharge should leave the patient confident that they are well enough for discharge home or to a facility.
Thomas, D. R. (2001). Issues and dilemmas in the prevention and treatment of pressure ulcers: A
The profession of nursing is always regarded as complex, dynamic and noble. The nursing profession requires many things such as hard work, vast knowledge, excellent communication skills, and a passion for the noble profession. All these qualities are needed to be an effective nurse. Today, nurses are living in a world of ever changing field of medicine. The present patient statistics pose, nurses are expected to take responsibility of accomplishing the requirements.
Big data has improved the quality of health care and further investment in expert knowledge solutions and infrastructures is needed to advance its use in healthcare although actions of doctors and nurses and the personal connection they have with their patients will always remain vital in providing high-quality care.
Often in rehab facilities, tasks are delegated to nursing assistants, who are not allowed to make assessments, but who also are not educated to be looking for slight changes in patient condition. Increased agitation and confusion can be attributed to lack of sleep, poor nutritional status, or even be considered a normal fluctuation in the patient’s dementia and may not be reported to a nurse. Oliguria and odor of urine may not be noticed by an aid in the event that the patient load was heavy, and is something that an aid may not realize is a critical factor to be reporting to the nurse on. Lastly, when a patient may not be able to express pain verbally, it requires healthcare providers to be familiar with them and make astute judgements based on their behaviors, vital signs, and overall affect/appearance to know that they are in
The author of the research study used a standardized test to determine the knowledge of ICU nurses on surgical site infections. The introduction allowed the readers to realize there is a country wide issue with surgical site infections (SSI). During the research, the quantitative approach was attempted by having a group of nurses take a multiple choice knowledge test consisting of three possible answers and the fourth choice of being I do not know. The test consisted of questions based on prevention guidelines. The group of 809 nurses attending the Flemish Society for critical care nurses were included in the study. Although, the test was timed the questions were reviewed by seven experts to determine the clearness of the questions. Statistics
Healthcare is constantly changing with the intention of improving patient care. The Institute of Medicine (IOM) issued a report introducing five core competencies for health professionals, in order to improve the Untied States healthcare system: provide patient-centered care, work in interdisciplinary teams, employ evidence-based practice, apply quality improvement, and utilize informatics (Institute of Medicine of the National Academies, 2003). IOM proposes that if all five core competencies are utilized by health professionals, quality patient care can be achieved. The facility in which this nurse work, is in need of improving their charting system. The facility currently utilizes two different software systems for charting, in addition to
This project started back in 1994 and according to the author has been an ongoing never ending project filled with staff education and teamwork. The results of this project was a dramatic reduction in the use of physical restraint and an overall feeling of improvement for the quality of life among patients. This article breaks down the methods used in order to achieve the goals sit for this hospital. This hospital is the largest in Virginia housing 250 patients at the start of this project, according to the author “44% of the total patient population were in restraints.” The first step was to gather a committee who brain stormed how to make their goals possible for their facility. Once making plans to go “restraint-appropriate versus restraint-free” patients were reevaluated by the entire team looking for alternatives to risk rather than resting on a restraint as an option. Moving forward with their goals they offered large amounts of staff re-education on restraints. This article talks about the setbacks of failed attempts at alternatives, showing that the staff in the hospital had a trial and error growing process. When patient injuries happened the staff assured everyone that they were in this together as a team. This article shows the overuse of restraints and the positive attitude to correct that overuse. This article will be part of my argument in the sense
Nursing is both a career and a calling since being a Christian nurse allows for the opportunity to show people the love of Christ through compassionate action. Nursing is a career full of unexpected events, which requires critical thinking skills. Nursing involves weighing the responsibility to carry out a task while taking into account the possible risks involved for both the patient as well as the nurse. With this in mind, the American Nurses Association holds, “that nurses are obligated to care for patients in a nondiscriminatory manner, with respect for all individuals” (American Nurses Association Position Statement On, 2015, p. 1). Therefore, it is the nurse’s responsibility to treat every patient or individual he or she encounters with