C489
Organizational Systems and Quality Leadership
Task 1
Western Governors University
Organizational Systems and Quality Leadership Task 1
A. Understanding of Nursing Quality Indicators
In 1998, the American Nurses Association established a national database that collected
information related to the quality of nursing care. The National Database of Nursing Quality
Indicators had two purposes: to provide data that was able to be compared by different healthcare
organizations and to try and better understand the link between nurse staffing and patient
outcomes. 10 indicators were identified, specific to nursing, and these are used to evaluate the
quality of patient care (Cherry & Jacob, 2019, p. 393).
When nursing sensitive indictors are used, patients’ outcomes are better because NSI's
are evidence based (Montalvo, 2007). When looking at the scenario, several things could have
been done differently and produced a better outcome for the patient. The first nursing sensitive
indictor is the prevalence of hospital acquired pressure ulcers. Since the patient already has a
reddened area on his lower spine, he is at higher risk for a pressure ulcer. Instead of answering
the daughter's questions about the reddened area, the CNA should have referred to the nurse
about this. The CNA is not qualified to assess the skin of the patient so the nurse should be doing
this at least every 2 hours while the patient is in restraints. The Braden Scale is a useful tool that
nurses can use when assessing skin. The patient should have been turned every 2 hours, and this
is something that can be delegated to the CNA.
Prevalence of restraints is another NSI that effects patient outcomes. The need for
restraints on this patient should be evaluated because the patient is not a harm to himself or
others. A fall risk assessment should be performed each shift to determine if the patient is still
