Nursing Sensitive Indicators
According to the American Nurses Association (ANA), nursing sensitive indicators are measures that show “the structure, process, and outcomes of nursing care” (Dykes & Collins, 2013). They are measurements that are connected to nursing care aimed at checking the status of the patient and the caregiver. The International Council of Nurses (2009) defines nursing quality indicators as changes in health conditions as a direct result of nursing care.
The nursing quality indicators as outlined by the ANA include patient falls, the occurrence of nosocomial infection, failure to rescue, the incidence of pressure sores, surgical patients’ complications, the prevalence of restraints, patient satisfaction, and nurses satisfaction among others (Montalvo, 2007; American Sentinel University, 2011). These outcome indicators are crucial in determining the quality of care being offered to patients. They are also essential for the enhancement of quality in service delivery as they assist in the appropriate allocation of resources according to the gaps revealed by the indicators (ICN, 2009).
Quality Patient Care
The utilization of nursing quality indicators assists caregivers to focus on quality and safety issues in patient care. The measurement of care outcomes is essential, as the collected data is helpful in monitoring the quality as well as the cost of care delivery (ICN, 2009). The correlation of nursing quality indicators and patient outcomes provides a basis for appropriate and efficient allocation of resources as nursing leaders can identify problematic areas in care delivery and address them accordingly (ICN, 2009). For instance, the CNA or a registered nurse should have documented the incidence of the pressure ulcer in Mr. J’s as well as other similar cases. The statistics obtained from the documentation would have prompted the supervisor and other caregivers to develop practice policies in the hospital to prevent pressure sores.
The rapid growth in technology has prompted healthcare facilities and professionals to adopt health information systems in their practice. Apart from assisting caregivers in documentation and clinical decision-making, health IT can also be helpful in populating standardized electronic data. This concept is known as e-measurement (Dykes & Collins, 2013). Therefore, medical facilities can make use of their clinical health systems to capture and analyze data related to nursing care and health outcomes. The resulting statistics on nursing sensitive indicators can be used to formulate nursing practices that will address issues in quality of care.
Alternatively, hospitals can install health IT interventions that target specific nursing quality indicators or use multifaceted health outcome systems to collect and analyze data. For example, the use of a fall prevention tool kit (FPTK) can significantly reduce the rate of patient falls by integrating risk assessment with a tailored fall prevention protocol to be followed by nurses and patient’s relatives (Dykes & Collins, 2013).
At the Denver Medical Center, we use the National Database of Nursing Quality Indicators (NDNQI) for data collection and evaluation of performance regarding nursing care. As the site coordinator, it is my responsibility to ensure that our nursing units are classified correctly and our data for each quarter is submitted to the NDNQI database. Quarterly reports from the NDNQI help us to make comparisons to other facilities as well as identify the areas that we need to work on to improve patient outcomes and satisfaction.
System Resources, Referrals, or Colleagues
My responsibility as a nurse supervisor is to ensure that my staffs respect patient’s dietary requests. To avoid the ethical dilemma resulting from Mr. J’s case, I would present the issue in our weekly nursing staff meeting, whereby I would ask the nurses to suggest ways of ensuring that patients get the correct food orders. We would then put measures in place to ensure that the nurse double-checks a food tray before it is given to the patient.
The hospital-wide Continuous Medical Education (CME) forum that is held every fortnight would be an effective avenue to educate staff members on the ethical implications of disregarding patient’s religious beliefs and directives. I would request the nursing manager from the Jewish hospital and our Jewish physician to facilitate the session with an aim of increasing the knowledge of staff members on the rationale behind the dietary requests made by Jewish as well as other patients.
References
American Sentinel University. (Nov. 2011). The 3 types of nursing sensitive indicators. Retrieved May 27, 2016, from http://www.americansentinel.edu/blog/2011/11/02/what-are-nursing-sensitive-quality-indicators-anyway/
Dykes, P., Collins, S., (2013). Building Linkages between Nursing Care and Improved Patient Outcomes: The Role of Health Information Technology. OJIN: The Online Journal of Issues in Nursing, 18(3), Manuscript 4
International Council of Nurses. (2009). Nursing sensitive outcome indicators. Retrieved May 27, 2016, from http://www.icn.ch/images/stories/documents/publications/fact_sheets/15c_FS-Nursing_Sensitive_Outcome_Indicators.pdf
Montalvo, I., (2007). The National Database of Nursing Quality IndicatorsTM (NDNQI®). OJIN: The Online Journal of Issues in Nursing, 12(3), Manuscript 2
