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Organizational Systems and Quality Leadership Task 1
A. Nursing Sensitive Indicators
C489 Organizational Systems and Quality Leadership Nurses are essential for the highest quality care patient care. They are on the front lines, the eyes and ears of the patient’s needs. Nursing sensitive indicators are specific to nursing and are influenced by nursing care. On the other hand, the experience and education of the nurse, the satisfaction of the nursing staff, staffing levels and staffing mix can affect patient satisfaction (Sauls, 2013). In the case of Mr. K, this patient with only mild dementia didn’t have to have restraints on in the first place, other diversions could have been used such as putting the patient closer to the nurse’s station, or a sitter could have been with the patient, a bed alarm could have been placed on the bed, etc. Since the daughter was in the room and he was reoriented, the restraints were not necessary at the time during her visit.
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Write My Essay For MeAs for the skin breakdown on his coccyx, this is highly preventable. This patient is supposed to be turned and repositioned every two hours while he is in bed. The registered nurse should have noticed this breakdown with his assessment. There would be at least two different registered nurses per day assessing the patient that should have noticed the redness. The staff member such as the CNA while bathing the patient should have noticed the redness and reported to the registered nurse as well. This is a total breakdown in communication. The patient’s daughter noticed when he stood up and the CNA was flippant with her concern.
Equally
critical is working as a team with other interdisciplinary members of the
hospital and hold them accountable. When Mr. J’s tray arrived and his diet was
not kosher as he had ordered it should have been sent back and the proper tray
delivered. The supervisor was wrong for stating to the staff to “keep it
quiet”, and the nurse was definitely wrong for stating “a little
pork never killed anyone”. A kosher diet is necessary according to his religion and needs to be respected. It is important to him and his family.
B. Quality Patient Care
Nurses
are at the front line to reduce suffering and deliver patient-centered care. By
providing a national database and RN surveys for examining relationships
between nursing and patient outcomes, the National Database of Nursing Quality
Indicators (NDNQI) delivers evidence to support the importance of nurse
sensitive measures in overall patient experience strategy. Over 2000 facilities
use it nationwide. Nursing quality indicators with patient experience and nurse
survey data to provide nursing leaders with a single, comprehensive source of
data. These form the foundation of a comprehensive nursing strategy to improve
care delivery and achieve the highest levels of performance. (Press Ganey) For
example, it is believed that staffing levels, the staffing mix (more RN’s
equals better patient outcomes), the education level of the RN (BSN equals
better care than associate degree prepared nurse). The It also measures patient
satisfaction scores, the number of pressure ulcers, and nosocomial infections.
If a nursing unit has a high number of pressure ulcers and a structure of the
unit many inexperienced nurses because of high turnover because of staff
satisfaction due to the fact that the patient-nurse load is 9-1 (with sharing a
CNA with another nurse) which will lead to the outcome of possible pressure
ulcer, possible nosocomial infection and probably poor patient satisfaction
because the nurse cannot possibly attend to every patient in a timely matter.
Hopefully a hospital seeing data like this could advance quality patient care
by changing the nurse to patient ratio which will lead to happier staff who can
do their job properly, which will lead to happier and safer patients which will
cut down on pressure sores and nosocomial infections and increase patient
satisfaction.
C. System Resources, Referrals, or Colleagues
The first thing as the supervisor that I would do is when it was mentioned by nursing staff that Mr. J’s meal was incorrect and was supposed to be kosher as he was Jewish, I wouldn’t have told the staff member to keep “quiet about it”. After calling the dietary supervisor and having his meal replaced with the proper diet, I would have called the daughter and explained and apologized for the error. I would also seek guidance from social services, pastoral services for further assistance. I would try to contact a local synagogue or perhaps the larger hospital system which is accustomed to serving the Jewish population about receiving information about religion and culture so the nursing staff as well as other departments, especially the kitchen management can be educated, and more culture sensitive and understanding. I would inform the hospital administration, the physician, and the family of Mr. J of this plan. Ethical issues need to be addressed up front and in a sensitive manner. Admit an error when it happens, apologize and make changes so it doesn’t happen again. Patients always come first and their culture and religion are important to them.
