Nursing Sensitive Indicators: A Case Study

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The Undesired Outcome
A. Nursing Sensitive Indicators
Nursing sensitive indicators (NSI) were identified in the 1990’s by the American Nurses Association (ANA) as a way to link patient outcomes to nurse staffing (Montalvo, 2007). NSI established indicators to focus on and to provide a means to evaluate the care given by nursing staff (Nursing sensitive indicators, 2013). The patient scenario might have ended differently if the NSI had been adhered to and utilized. NSI’s have shown if a certain processes are followed then a certain outcomes would be achieved. The value of using an evidence based process are that evidence has shown that these processes are effective (NSI, 2013). The pressure ulcer and restraint use are under the NSI. The outcomes
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The patient fell at home, but the cause should be investigated to assess if it was due to clutter, medication dosing, orthostatic hypotension or any number of factors. Current status of the patient was that he could answer simple questions, and was cognizant of the fact he was in restraints and had to use the bathroom. The NSI would have laid out a path to follow to care for this patient. The patient could have been placed closer to the nurses station. Elderly patients have more problems with confusion when admitted to the hospital (Mauk, 2009). Frequent reorientation of the patient to his surroundings and the addition of a sitter were possibilities (Mauk, 2009). Use of best practices that are shared by NSI would lead to decreased use of restraints. Restraint use can increase the risk for injury or falls (Mauk, 2009). NSI affects the quality of patient care in many ways besides the two mentioned …show more content…
The patient would have been apologized to and given information about what was being done to correct the situation. A multi-disciplinary team to address the situation would be formed of the following: nursing staff, physicians, dietary, administrator, social workers, chaplain, Jewish community leader, representative from the larger hospital that usually cared for a large Jewish population. A root cause analysis would have been conducted to determine what went wrong and how it could be avoided in the future (IHI, PS 104, 2010). Cultural sensitivity would be observed, with educational materials about the Jewish faith and any other prevalent minorities in the area. The patient would have been assured that in the future their values, culture, and beliefs would be taken into account (IHI, PFC 101, 2011).
The nursing supervisor would have created a safety culture so all staff would have felt enabled to report the diet mistake (IHI, PS 106, 2011). Keeping quiet and not reporting the mistake causes the hospital to appear distrustful to patients. Patients might wonder what else the hospital had not reported. There would need to be a change in the attitude in the hospital as a whole to embrace the

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