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The importance of nursing-sensitive indicators and their impact on patient outcomes. It highlights the role of the American Nurses Association's national database of nursing quality indicators (NDNQI) in providing data on nursing quality indicators and patient outcomes. The document also discusses the importance of ongoing training for healthcare workers on indications, risks, complications, and procedures related to restraint use and alternative measures to manage vulnerable patients. a scenario of Mr. J's hospitalization and discusses the importance of monitoring nursing quality indicators such as pressure ulcers and restraint prevalence.
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C489 Task 1 Nursing-Quality Indicators Western Governors University As nurses, it is crucial to understand and comprehend the concept of nursing-sensitive indicators. The quality of nursing care influences the patient’s hospital stay and outcomes. To help provide the best and safest patient care, the American Nurses Association has created a national database of nursing quality indicators (NDNQI) to provide data collected from thousands of facilities in the United States. This data analyzes a specific set of nursing quality indicators and patient outcomes and considers how nurse’s play an important role in patient outcomes (Montalvo, I. 2007). Nursing indicators such as development of pressure ulcers, physical restraint prevalence and patient/family satisfaction can aid in interpreting hazardous issues in patient care. Hospital data on nursing quality indicators such as measuring pressure ulcers right away, monitoring them for break down, and repositioning patients on a regular schedule, have shown to help prevent additional skin breakdown (Montalvo, I. 2007). Hospital data on restraint prevalence have shown restraints being used to prevent patients from falling by getting out of bed without assistance, prevent from removing medical equipment, and reduce potential for inflicting harm to self and others (Nursing skill mix, nurse staffing level, and physical restraint use in US hospitals: a longitudinal study, 2017). Hospital data has shown the importance of ongoing training for health care workers on indications, risks, complications, and procedures related to restraint use and that health care personnel need continuing education on alternative measures to manage vulnerable patients. A policy on the use of restraint and comprehensive guidelines need to be available to guide health care practitioners in the management of patients where restraint cannot be avoided (Nursing skill mix, nurse staffing level, and physical restraint use in US hospitals: a longitudinal study, 2017).
In the scenario of Mr. J’s hospitalization, numerous NDNQI are presented. Mr. J is an elderly retired rabbi with a case of mild dementia who fractured his hip after a fall at home. Due to Mr. J’s age, previous falls, mild dementia, and current pain management regimen, Mr.’ J has a much higher prevalence of falling during his hospital stay. Patients who are a fall risk should be closely monitored for any cognitive and physical changes during their hospital stay. If any changes were to happen, proper documentation is needed so nurses and staff can continue to provide safe care. Part of our job as nurses are to chart patient repositions every 2 hours and assess patient’s skin and breakdown by using the Braden chart. The nurse and CNA taking care of Mr. J need to be aware of his fall risk and weigh the outcome and benefit of restraints. There is no evidence in this scenario for a reason for him to be restrained. He is unable to move or use his call light to use the restroom, and now has redness on his backside because he has been laying in one spot for so long. By lying in bed day after day, he is more prone to develop additional bedsores which will complicate his stay even more. Routinely monitoring restraint prevalence would help staff document accordingly why restraints are necessary. Hospital-acquired pressure ulcers develop due to immobility, it is the nursing staff’s responsibility to reposition immobile patients at regular scheduled times. Mr. J’s daughter visualized a red depressed area on Mr. J’s spine, which describes a Stage 1 pressure ulcer. The fact the CNA told the daughter “It will go away when he gets up” shows lack of education and need for further teaching on pressure ulcers to staff. Identifying the deficiencies and scope of the problem will allow them to be addressed and ultimately result in an overall improvement in the quality of patient care.