Nurse-Sensitive Indicators Analysis
This is an analysis of the nurse-sensitive indicators in a case study regarding an elderly, Jewish male patient with dementia in a hospital setting. Nurse-sensitive indicators presented in the scenario such as patient falls, using restraints, development of pressure ulcers, and patient satisfaction will be discussed. When nurses are aware of these nurse-sensitive issues they can provide better care for their patients. There are multiple resources available to nursing staff to help resolve ethical issues. Nursing-Sensitive Indicators
The American Nurses Association has identified several areas of patient care as indicators to improve the care patients receive from nursing staff. These nurse-sensitive indicators can change the outcomes of the care nurses provide. Nurses need to be aware of these indicators so they understand the relationship between the care they provide and the results their patient’s experience. The patient presented in the case study is a male dementia patient that fell at home and fractured his hip. He is restrained in his bed and sleepy from pain medication use. He has specific cultural and religious preferences that affect his diet. Nurse-sensitive indicators included in this scenario are a fall at home, the use of restraints, a possible pressure ulcer, and overall patient satisfaction. The use of restraints in the scenario presented seems unnecessary. The patient is a falls risk due to his previous fall at home but does not present as a candidate for restraint use. He is sleepy and compliant. The care of this patient is compromised by the use of restraints which are leading to the development of a pressure ulcer on the patient’s back.
A bed alarm would be more appropriate and would provide a better outcome for this patient. The issue is brought to the attention of the nurse’s aid but whether through negligence or ignorance does not intervene for the patient. There is also a general lack of concern for the religious preferences of the patient when he consumes the wrong diet and the staff attempts to hide the incident rather than make an apology to the patient and his family. Trust between care providers and patient and patient family break down when mistakes are hidden rather than acknowledged and fixed. Due to lack of accountability for the error the family takes the complaint to the physician who furthers the grievance to the administration. Hopefully the administrations awareness of this issue will lead to a more empathetic handling of patient preference in the future than how staff is currently handling Jewish patient diet preferences now. Quality Patient Care
Nurses that focus on patient outcomes can advance the level of patient care throughout the hospital. Nurses aware of these indicators are able to pay special attention to the quality of care they are giving to patients that achieve the best outcomes for their patients. The Collaborative Alliance for Nursing Outcomes (CALNOC) measures the prevalence of pressure ulcer and restraint use in acute care. They report with preventative measures the majority of pressure ulcers can be avoided (Stotts, 2013). By not using restraints on patients nurses can decrease the likelihood that the patient will develop a pressure ulcer. This would provide a better outcome for the patient. When patient outcomes improve the level of care throughout the hospital improves. .
System Resources, Referrals, or Colleagues
There are several ethical issues involved in this scenario. These concerns are the use of restraints on a non combative, sleepy patient, second the total dismissal of the patient’s food preferences as a Jewish rabbi, and last the development of a pressure ulcer due to the patient’s immobility. There are resources available to assist nursing staff when ethical patient issues arise. Ethical resources available to nurses with concerns regarding patients can be found on the American Nurses Association (ANA) website specifically The Code of Ethics for Nurses. This source offers ethical information and guidelines on a variety of topics that may take place for practicing nurses. Other resource staff available is the nurse manager, social worker, and nurse case manager. These individuals can provide course of actions for nursing staff or act as liaisons to help institute necessary changes for better patient care. Staff education can be provided by the Jewish physician or another educated staff member to better serve the needs of this segment of the community. A better understanding of the beliefs and culture of the patients nurses serve will help improve their patient care. Most hospitals have an internal system of reporting where employees can alert upper management of problems that arise. This type of reporting is problem solving based and not blame based. A report on the ethical problems on this patient should be generated to protect future patients and improve the care this hospital offers. Conclusion
In conclusion, when nurses are aware of nurse-sensitive indicators it improves the quality of care patients receive and the outcome for that patient. Seeking outside resources such as nurse managers, case managers, social workers or the physician themselves can assist in providing the best interdisciplinary team for quality patient care.
