Nurse sensitive indicators measure the application of nursing care and how it affects the patients’ outcome and satisfaction of care. The care and treatment of patients is critical in determining the quality of health care delivery and the results of patient care. “The structure of nursing care is indicated by the supply of nursing staff, the skill level of the nursing staff, and the education/certification of the nursing staff. Patient outcomes that are determined to be nursing sensitive are those that improve if there is a greater quantity or quality of nursing care”, (“Nurse Quality Indicators”, 2014). Comprehending nurse sensitive indicators greatly enhances patient treatment and the ability to distinguish concerns that may disrupt a patient’s care and positive outcome. Health care teams regulate these occurrences by identifying, monitoring, and measuring such indicators like the increasing incidences of hospital acquired pressure ulcers. The maintenance of skin integrity and the prevention of pressure ulcers play a significant role in the quality of care. Reduction in pressure ulcers requires prevention protocols, which consist of preventive interventions, based on risk levels, with implementation of risk assessment scales like the Braden scale or Norton scale, evidence based practice, leadership, and education.
Impact on Patient Safety and Quality
Due to the high risk that pressure ulcers impose on the health of patients, nurses play a vital role in the prevention and treatment. “A pressure ulcer is a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure or pressure in combination with shear and/or friction”, (Gulanick & Myers, 2014). All patients, no matter what age, ...
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Conclusion
Hospital acquired pressure ulcers is a major nurse sensitive indicator and nurses greatly impact the development and prevention. Prevention of hospital acquired pressure ulcers often involves minimal use of equipment, but requires attentive caution to treat the continually increasing risks associated with the development of pressure ulcers. Not all pressure ulcers can be prevented, but the use of comprehensive pressure ulcer programs can prevent the majority of its development, (Gulanick & Myers, 2014). When a pressure ulcer develops, the goals of healing or preventing deterioration and infection are paramount. As leaders, nurses must take initiative in constantly educating themselves about new successful interventions and implementing evidenced-based practice and take action in the prevention before risk factors are detected.
Willock et al, (2007) developed a detailed questionnaire based on a paediatric and adult pressure ulcer literature. A survey of 265 in patients in a paediatric hospital in the UK was conducted so detailed data could be obtained. The study found anaemia emerged as being a highly significant aspect of determining pressure ulcers. As a result of this study, the Glamorgan scale was
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
Nurses are key components in health care. Their role in today’s healthcare system goes beyond bedside care, making them the last line of defense to prevent negative patient outcomes (Sherwood & Zomorodi, 2014). As part of the interdisciplinary team, nurses have the responsibility to provide the safest care while maintaining quality. In order to meet this two healthcare system demands, the Quality and Safety Education for Nurses (QSEN) project defined six competencies to be used as a framework for future and current nurses (Sherwood & Zomorodi, 2014). These competencies cover all areas of nursing practice: patient-centered care, teamwork and collaboration, evidence-based practice, quality
Utilizing this tool will allow The Restorative Nurse and Wound Nurse to generate a graph based off of the data retrieved from the Center of Medicare and Medicaid Services (CMS) quarterly Quality Measures Report (APPENDIX B). The Wound Nurse and Restorative Nurse will start with the last data reported before the start of the On-Time Project and then graph the data every three months during the On-Time Project for the following areas: falls, weight loss, in- house acquired pressure injuries and nosocomial infection. For that purpose, to monitor the effectiveness of the On- Time Project the Wound Nurse and Restorative Nurse will provide a designated share drive to present to the Director of Nursing and other stakeholders on a quarterly schedule at the quarterly Quality Assurance Improvement Program(QAIP)
A study conducted by the Centers for Disease Control and Prevention shows that “annually approximately 1.7 million hospitalized patients acquire infections while being treated for other medical conditions, and more than 98,000 of these patients will die as a result of their acquired infection” (Cimiotti et al., 2012, p. 486). It was suggested that nursing burnout has been linked to suboptimal patient care and patient dissatisfaction. Also, the study shows that if the percentage of nurses with high burnout could be reduced to 10% from an average of 30%, approximately five thousand infections would be prevented (Cimiotti et al., 2012). In summary, increasing nursing staffing and reduction burnout in RNs is a promising strategy to help control urinary and surgical infections in acute care facilities (Cimiotti et al.,
The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu...
The paper will address the problem of nurse hostility toward each other. It will address the etiology of the problem, and suggest some possible solutions or therapy to the problem. It will be discovered if truly preventive programs such as violence-prevention programs
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
O’Daniel, M., & A.H., R. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: Agency for Healthcare Research and Quality. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2637/
The field of nursing is an ‘in-demand’ profession that strives for excellence in patient care and positive outcomes. A nurse’s care is always patient-focused with the goal of helping patients reach maximum medical improvement. The job of a nurse can be physically, mentally, and emotionally challenging at times. This can lead to occupational burnout which has been linked to suboptimal medical care (Cimiotti, Aiken, Sloane, and Wu, 2012). The impact of sub par health care, results in a higher number of hospital-acquired infections (HAIs) and poor patient outcomes. Implementation of infection control practices and HAI prevention programs are two of the most important aspects of nursing care being utilized to improve patient outcomes. The effect of nurse staffing configurations and nurse-to-patient ratios have also been shown to play a significant role in the relationship between nurses and HAIs.
Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20 Haugen, N., Galura, S., & Ulrich, S. P. (2011). Ulrich & Canale's nursing care planning guides: Prioritization, delegation, and critical thinking. Maryland Heights, Mo. : Saunders/Elsevier.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
In response to concerns about staffing and quality of care, the American Nurses Association (ANA) launched the Patient Safety and Nursing Quality Initiatives in 1994 to address the impact of health care restructuring on patient care and nursing. To facilitate the initiative, ANA established the National Database of Nursing Quality Indicators (NDNQI) in 1997, with two goals: (1) to develop a database that would support empirical monitoring of the impact of nurse staffing on patient safety and quality of care across the nation, and (2) to provide individual hospitals with a quality improvement tool that includes national comparisons of nurse staffing and patient outcomes with similar hospi...