ORG. SYSTEMS & QUALITY LEADERSHIP TASK 1 1
Organizational Systems and Quality Leadership
Task 1
Stephanie N. Campbell
000499473
Western Governors University
ORG. SYSTEMS & QUALITY LEADERSHIP TASK 1 2
Organizational Systems and Quality Leadership Task 1
A. Nursing Sensitive Indicators In this given scenario, there are multiple nursing sensitive indicators present including pressure ulcer prevalence, restraint prevalence, and skill mix. (Montalvo, 2007) The most prevalent one for me was pressure ulcer prevalence. Yes, in this case, the pressure ulcer was likely secondary to restraint use, so these tie in together, but pressure ulcers overall are easy to prevent using proper turning and
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ORG. SYSTEMS & QUALITY LEADERSHIP TASK 1 4
The size of the facility could also have an impact on how NSI data is collected. A very small rural community hospital may not be able to create a large committee to view data and develop a plan. They may need to reach out to larger hospitals to see what they have done and how it has worked. Implementation may be slightly different, but the end result should be comparable. In that same sense, a very large city hospital may be able to create a large committee with multiple disciplinarys all lending their expertise to the plan and may be able to create a much more detailed plan of action. Regardless, a plan of action needs to be made if there is an issue with negative impact of a particular NSI.
C. System Resources, Referrals, or Colleagues
There are many resources than can be used in this scenario to alleviate the ethical dilemma presented near the end of the scenario. The patient is Jewish and therefore has a strict diet of Kosher foods. The diet order was originally placed correctly, but the patient was served only partially correct as he did not receive a Kosher meal, but the other aspects of his diet were followed. Diet orders should be checked before bringing patients their food and again with the patient at the bedside. However, the staff never should have tried to “cover it up” and do not understand the implications of the patient eating non-Kosher foods. There are many resources than can
A) There are several issues in the case of Mr. J that need to be examined. Using nurse sensitive indicators “reflect patient outcomes that are determined to be nursingsensitive because they depend on the quality or quantity of nursing care” (American Sentinel University, 2011). Mr. J. was not receiving acceptable care, because his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. This skin condition is the first stage of a developing pressure ulcer. a. Nurses should be aware that a patient with limited mobility is at risk for skin breakdown, and pressure ulcers.
Strategic Planning is an essential first step in the development of a result-base accountability system,” (Schilder, 2013, p. 1). In strategic planning an organization must know their goals, missions, and how to reach them. Health care facilities are in huge demand for the elderly and for people who lives in low-income communities. A person who receives good quality health care services can prevent the spread of contagious diseases. This paper will describe the need of the community, population it is serving, and a brief description of the facility.
The structure, processes, and outcome factors of nursing care are reflected in Nursing-Sensitive Indicators (NSIs). There are several things that the nurses in the provided scenario could have done to promote quality patient care. By being aware of restraint use as an NSI the hospital staff would be more likely to increase their focus and attention to its need and any development of complications. This increased focus and attention could have led to the development of educational opportunities for the hospital staff on the identification of pressure ulcer related complications. Had the nurse and nursing
Data can be collected on multiple ways, from the point of medical care and patient satisfaction. The scenario points to pressure ulcers and the use of restraints, in both situations I believe that there was a fundamental lack of knowledge by the staff and disconnect by management.
Now, the quality improvement department will need to determine what processes can be modified to improve outcomes. For example, if they see an increase in pressure sores and prevalence of restraints. They could use computerized charting and order entry, along with the evidence-based guidelines, to identify specific groups of patients who are vulnerable to developing pressure ulcers or closely monitoring use of restraints. With early identification, automatic orders for preventive interventions can be implemented quickly. With the assistance of the automated consults and orders, the appropriate equipment, the interdisciplinary task force, continuing education, and monitoring, the hospital system would be able to reduce unnecessary use of restraints and hospital-acquired pressure ulcer prevalence rate (Cherry & Jacob, 2010).
Their existing system and reputation have already set them apart as a market leader and has proven to be a profitable setup. However, there is still an unmet demand. Option 1 to add 50% more beds may not be beneficial if we don't also increase operation. Increasing the number of bed by 50% would not be advisable unless they would add more surgeons and operating rooms because the existing operating
In this scenario the hospital in order to advance the quality of care, could have shared the information about the incident with the nursing personnel. The hospital could provide the best quality of care to the patients and achieve the patients’ satisfaction, by sharing the data. Advancing the quality of care would have positive effect on both patient satisfaction and nursing care. Knowledge of nursing care empowers the nursing staff in such cases. In this scenario the knowledge of pressure ulcers, restraints and patient care is significant. On the other hand the nursing care in this scenario could have been better and the family/patient could have been cared better if the nursing staff had gotten the best patient care knowledge.
The ethical committee should intervene to determine the ethical responsibilities of the medical and administrative staff. The people involved should be held accountable and give them the opportunity to communicate the patients about the medical
Nursing Sensitive Indicators The Nursing Sensitive Indicators found in this scenario are patient satisfaction with nursing care, patient satisfaction with overall care, and pressure ulcers. If the staff were to have an understanding of what Nursing Sensitive Indicators are, this can assist them to identify issues that may have interfered with Mr. J’s patient care. The nursing staff should have had the proper knowledge of restraint use, like assessing the patient every two hours to see if restraints are even appropriate, assessing the patient’s vitals, circulatory status, and skin integrity (Joint Commission, 2010), removing and repositioning the restraints every two hours, repositioning the patient every two hours, and offering Mr J frequent bathroom breaks and sips of water. In this scenario it is reported that Mr J has a spot on his back that is red, as a nurse this is an indicator of a
McDonagh (2013) stated that pressure ulcer is a one of the indicator to represent of quality of patient care. University Hospitals Coventry and Warwickshire Trust in England carried out a special campaign to prevent and to remove avoidable pressure ulcer with use of several strategies such as “Root cause analysis and performance review, equipment gap analysis, “documentation review, review of staff education, 100 Days free campaign, and use of social media” (McDonagh, 2013). McDonagh (2013) mentioned that “Root cause analysis and performance review” is an analyzing tool for patient safety incidents thus it helps to prevent safety incidents. During this special campaign, nursing staff’s education was empathized and Tissue Viability Team developed
Mr. J.’s daughter noticed a red mark on her father who then reported this to the nursing assistant and her concerns were immediately dismissed. If the nursing assistant was properly trained in the use of restraints and had knowledge of patient outcomes, this patient would not have developed a pressure ulcer. The nursing assistant should have immediately informed the nurse and measurements should have been taken to prevent further breakdown of the patient’s skin which was not done. It is evident in reading this case that Mr. J developed a Stage I pressure ulcer from being retrained in one position with no assessment or release for an undetermined amount of time.
However, only 10% of nurses actually complete accurate inspections of the skin during their initial physical assessments of the patients (Lahmann et al., 2010). As a result, patients who are at risk of developing pressure ulcers are often overlooked by nursing staff.
care outcomes, as well as benchmark data to assess current practice,” (Sherwood, 2014). American Nurses Association has a National Database of Nursing Quality Indicators looks for a cause for common healthcare issues, such as “surgical site infections, pain assessment, pressure ulcer development, and falls,” (Sherwood, 2014) to better understand how these things came about to possibly prevent in the future.
Pressure ulcers are painful and can be difficult to treat. Pressure ulcer prevention should be a part of everyday nursing practice. Pressure ulcer prevention is a nursing practice priority across all care settings. With the new Centers for Medicare and Medicaid regulations regarding pressure ulcers now in effect, prevention is more critical than ever. However, nurses cannot expect to make significant progress in preventing pressure ulcers if pressure ulcer risk assessment, prevention planning, prevention intervention, and outcomes evaluation function as distinct and unrelated activities.
Nursing-sensitive indicators can be an important tool in identifying patient care issues that could potentially arise during a hospital stay. By analyzing the data on specific nursing-sensitive indicators, the quality of patient care can be optimized and patient satisfaction can be improved. The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. The use of available resources, staffing by acuity and patient needs, appropriate referral indicators, and cooperation