...Organizational Systems & Quality Leadership Rtt1 Task Currently, the most critical issues in health care are safety and quality of patient care due to changes in health care delivery. Facilities have an emphasis on the bottom line and finding areas to cut costs. Cost cutting measures include a decrease in the number of nurses to provide direct patient care and shorter lengths of stay due to reimbursement changes. This means fewer nurses caring for sicker patients putting patient care in jeopardy (ANA, 2015). Indicators are measured to monitor safety and quality of care. Nursing-sensitive indicators gauge aspects of patient care directly related to the quality and quantity of nursing care. Nursing-sensitive indicators measure the process of care, the structure of care, and patient focused outcomes. Process indicators measure methods of assessment, intervention, and nurse job satisfaction. Structure indicators include the supply of nursing staff, skill level, and education. Outcome indicators are those that improve if there is a greater quantity or quality of nursing care. These indicators help determine links between patient outcomes and the nursing care provided (American Sentinel University, 2015). Since 1998, indicators have been reported to the National Database of Nursing Quality Indicators (NDNQI). That data has been used to evaluate nursing care at the unit level (Montalvo, 2007). In this scenario, Mr. J was restrained, developed a pressure ulcer, and his...
Words: 706 - Pages: 3
...Running head: NURSING SENSITIVE INDICATORS 1 RTT1 Task 1 Krista Vandiver, RN, CEN Western Governors University NURSING SENSITIVE INDICATORS Nursing-Sensitive Indicators According to the American Nurses Association, nursing-sensitive indicators “reflect the structure, process and outcomes of nursing care.” ("Nursing Sensitive Indicators," 2015) Understanding the indicators is an important piece of nursing, not only to assist the patient, but the patients loved ones as well, to ensure quality patient care. In this particular case, had the 2 nurse understood the reasoning and data behind the Pressure Ulcer Rate and Restraint indicators, and communicated the necessity to report any pertinent findings the CNA may discover in the nurse’s absence, the CNA would not have dismissed the reddened area over the patient’s lower spine and would have immediately informed the nurse of the finding. Upon returning the patient to bed, the CNA would have also known not to place the patient back in bed on his back and reapply the restraints. Instead, would have had the patient lay to one side and stressed the importance, to the patient and family member, of frequent turning, to reduce the chance of pressure ulcers. Quality patient care can only be achieved with teamwork and open communication. The discussion of pressure ulcers in hospitalized patients has become an increasing issue with more attention to the prevention of such since the early to mid-1990’s. The Centers for Medicare...
Words: 860 - Pages: 4
...Toni Johnson RTT1 Task 1 November 4, 2014 A. Nursing Sensitive Indicators One important element of working in the medical field is understanding nursing sensitive indicators. These indicators reflect the structure, the process and the outcomes of nursing care. Structure indicators include the number of nurses on staff as well as the education and skills of the nursing staff. Process indicators measure aspects of nursing care such as assessment, intervention and nurse job satisfaction. Outcome indicators measure the quality and quantity of nursing care, which include satisfaction with pain management, falls and pressure ulcers. (American Nursing Association 2014) In the case of Mr J sensitive structures would include understanding by the nurse and CNA that leaving Mr J in his bed while on his back could lead to skin breakdown. This knowledge would prompt the CNA to avoid positioning the patient on his back and the CNA would know to reposition him frequently to avoid pressure ulcers. The knowledge would also allow the CNA to recognize the reddened area as a stage one pressure ulcer and the information would then be passed on to the RN for needed intervention. Knowledge would allow the nurses to assess whether the use of restraints were appropriate for the patient as well as the proper use of the restraints. Outcome indicators for patient satisfaction would have been improved had the nurses insured a correct diet and if the nurse had not minimized the situation...
Words: 803 - Pages: 4
...Organizational Systems & Quality Leadership RTT1 Task 1 Willem Botha Western Governors University Texas Nursing-sensitive indicators consist out of three categories that include the following: Structure, process and outcome. Structure refers to the organizational aspect of nursing that is made up of staffing levels; experience vs inexperience; educational levels or the make-up staffing at any point on the unit or facility. The Process is aspect of policies and procedures at the facility and Outcomes are determined when greater levels of nursing care and quantity are involved with better patient outcomes (ANA, 2015). Nursing-Sensitive Indicators The scenario paints a picture of multiple areas that should be approved on and addressed by management. The use of restraints, as described by the scenario, indicates a clear lack of knowledge in regards to nursing-sensitive indicators, the use of restraints and subsequent pressure ulcer formation is directly related and reflects on all 3 aspects of the indicators. The American Nurses Association, ANA, recommends that restraints only be used when no other viable options are available and this is also the case with the organization that I am involved with as a RN, Seton Health. While reading the scenario, it did not mention patient behavior that would justify the use of restraints; there is no mention of medical or behavioral interference that could possibly require the need to use restraints. The patient is elderly, has a history...
Words: 1321 - Pages: 6
...RTT1 Organizational Systems Task 2 The purpose of this paper is to analyze the unfortunate sentinel event of Mr. B, a sixty-seven-year-old patient presenting with severe left leg pain at the emergency room. A root cause analysis is necessary to investigate the causative factors that led to the sentinel event. The errors or hazards in care in the Mr. B scenario will be identified. Change theory will be utilized to develop an appropriate improvement plan to decrease the likelihood of a reoccurrence of the outcome of the Mr. B scenario. A Failure Modes and Effects Analysis (FMEA) will be used to project the likelihood that the suggested improvement plan would not fail. Lastly, key roles nurses would play in improving the quality of care in the Mr. B scenario will be discussed. A. Root Cause Analysis A root cause analysis (RCA) is “a process for identifying the basic or causal factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event” (Cherry & Jacob, 2011, p. 442). The participants during the root cause analysis would be the emergency room physician (Dr. T.), the Mr. B’s LPN and RN (Nurse J) during the time of the sentinel event, the emergency room nurse manager, and the chief nursing officer (CNO) of the hospital. These members would meet in a root cause analysis meeting to discuss the causative factors that created Mr. B’s sentinel event. The first step in a root cause analysis on the sentinel event that caused...
Words: 1738 - Pages: 7
