Nursing Quality Indicators

Nursing-Quality Indicators Case Study

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Nursing-Quality Indicators Case Study

Application of Nursing-Quality Indicators

Evidence suggests that nurses who correctly understand the significance of quality indicators are more likely to provide quality care for their patients; the reverse is also true (Heslop & Lu, 2014). The nurse providing care to Mr. J demonstrated little understanding of complications such as pressure ulcers as a nursing-quality indicator. When Mr. J’s daughter noticed a depressed red spot on her father’s spine, the nurse should have immediately applied different interventions because this was a clear case of pressure ulcers. Repositioning Mr. J after returning him to bed from the bathroom or supporting him with pillows would have reduced the risk of developing more severe depressions on his body (Joseph & Samson, 2016). A repositioning schedule of 2-3 hours would be the most effective approach of reducing the risk of developing more pressure ulcers for Mr. J.

        Although Mr. J had mild dementia, quality indicators would help the nurse to reassess the need for using physical restraints at the expense of other alternatives. Restraining Mr. J was the primary reason why he developed pressure ulcers on his spine because he could not reposition himself freely on the bed (Xiong, Qiao, Cheng, Shuwen, 2017). Alternatives such as using a bed alarm would be more effective whenever Mr. J needed to use the bathroom and thus would be able to move freely. Additionally, literature links restraints use with reduced patient satisfaction (Joseph & Samson, 2016). Generally, applying quality indicators such as complications (pressure ulcers), restraint prevalence and patient satisfaction would have helped the nurse to know that regular repositioning is essential to reduce the risk of developing pressure ulcers while improving the comfort of the patient thus patient satisfaction (Heslop & Lu, 2014).

Advancing Quality Patient Care

Hospitals often collect, analyze, report and monitor quality indicator data with the primary goal of improving the quality of care across all of its departments. In theory, hospital data aids health facilities to identify areas that require improvement and thus the implementation of interventions that realize better health outcomes, increased efficiencies and low costs (Xiong, Qiao, Cheng, Shuwen, 2017). However, in practice, existing literature indicates that most hospitals have difficulties in finding any meaningful data. In Mr. J’s case study, hospital data on patient satisfaction, the incidence of pressure ulcers and restraint prevalence would be instrumental in various ways to improve the quality of care in the hospital. Hospital data on the prevalence of pressure ulcers helps the nurses to know the frequency of patients who are developing PUs among the hospitalized patients across all age groups thus prompting the hospital to seek a surrogate measure of treating PU; surgical treatment particularly for patients with severe cases (Sarkar, 2015). Additionally, the data will also enable the hospital to realize the weight of the problem and apply the traditional methods of controlling PUs such as repositioning the patient and support using pillows.

Pearl (2015) conducted a study that determined how data on restraint prevalence could be used to improve patient safety. He notes that using restraints had not only adverse effects on the physical health of the patient but also their emotional status (Pearl, 2015). Therefore, hospital data on restraint prevalence would help health professionals to identify the risks that are associated with restraining patients and investigation of existing alternative interventions that would meet the patient needs as well as keep them safe. For example, having a sitter for Mr. J rather than restrain use prevents patient fall as well as keeping him comfortable (Lacey, Klaus, Smith, & Cox, 2016). The assigned sitter would be responsible for repositioning the patient after the detailed repositioning schedule as instructed by the physician. Generally, data on restraint prevalence helps the hospital to determine the effects that the restraints have on the patients and weigh the negative consequences against positive ones thus establishing the need for alternative approaches to patient safety (Sarkar, 2015). Alternative methods include using bedside alarms, using sitters, hiring additional staff and collaborating with physicians.