Nursing-sensitive indicators

Nursing-Sensitive Indicators

Nursing-sensitive indicators are used in healthcare institutions to promote and improve the quality of patient care provided by nurses while also ensuring the patient's safety. These indicators indicate the organization's principles, procedures, and goods used to provide patient care. In the example involving Mr. J, the nursing-sensitive indicators can be used to detect concerns that disrupted the flow of quality patient care (Doran & Almost, 2003). In the healthcare that MR. J was being treated the nurses needed to have a solid understanding of the sensitive indicators so that they can identify and prevent some of the issues that were interfering with the flow of patient care for MR. J.

Understanding Nursing-Sensitive Indicators

First, some of the issues in MR. J scenario could have been prevented if he nurses had an understanding and knowledge of appropriate restraint use and the care involved. Knowledge of the care involved when caring for a patient in restraints would have prevented pressure ulcers which were visible on Mr. J back. In this scenario, if the nurse had the necessary knowledge for caring for a restrained patient. The nurse would have been giving Mr. J frequent breaks from restraints, assisted him in accessing the bathroom more often during the breaks and turned Mr. J from side to side at least in a two-hour intervals.

Secondly, the meal that Mr. J was served with was inappropriate according to his request. Mr. J's meal order was regular kosher chopped meat. However, he was served with pork chop cutlet. The nursing caring for Mr. J noticed the mix-up, but the supervising nursing encouraged the nurse to keep quiet about the issue and did not inform Mr. J's daughter about the mistake. Mistakes are usually bound to happen in any situation, however, failing to acknowledge the error and informing the family of the patient about the mistake was insensitive in the part of the nurses considering the locality of the healthcare facility was mostly Jews who did not consume pork. As a result of the cultural insensitivity by the nurses, the patient satisfaction of the care given is negative.

Lastly, the comments by the nurse that half a pork cutlet has never killed anyone can be considered rude and insensitive to the locals of the area who are the primary patients of the health facility. Therefore, having an understanding of nursing-sensitive indicators in this scenario would have prevented most of the negative outcomes in this case.

Hospital Data and Nursing-Sensitive Indicators

The quality of patient care throughout the hospital can be advanced by hospital data on appropriate nursing-sensitive indicators. For instance, the hospital should contain data on the prevalence of pressure ulcers in patients with restraints; the data could be analyzed to determine nursing practices that can reduce this occurrence. Hospital data about pressure ulcers can be studied by a committee of experts in the hospital and identify the causes of these pressure ulcers (Doran & Almost, 2003). After identifying the causes of the pressure ulcers, the board can find ways and practices that the hospital can use to prevent and reduce the cases of pressure ulcers.

Furthermore, the hospital should contain data about the use of restraint among patients. The data on restraints utilization in the hospital can be analyzed to improve patient's satisfaction and outcome on the procedures. The analysis on the use of restraints in the hospital can determine the scenarios which require the use of restraints and those situations where other methods should be used before resorting to the use of restraints. In the case, where a patient such Mr. J has to be restrained the hospital should keep proper documentation that can be used to determine the quality of care that the patient received during the period of restraints. The hospital data should outline some of the patient care to be given to patients on restraints. For instance, the hospital data should state the period when the restraints should be removed from the patient for a break. Additionally, the hospital should encourage the nurse to conduct motion exercises on the extremities affected by the restraints (Doran & Almost, 2003). There should be proper documentation by the nurses who should reflect on the assessments performed on the patient and the precautions that were taken.

System Resources Analysis

In the case involving Mr. J there as several system resources that the nursing shift supervisor can use to address and resolve the ethical issue. First, as the nursing supervisor when I am informed of the mix-up with the patient meal, the step to take would have to report to the patient's daughter when she arrived and notified the dietary department about the mix-up. Additionally, the staff of the floor would have been told to double check the meals being served and ensure they are according to the order of the patients (Doran & Almost, 2003).

The use of restraints resulting in pressure ulcers was another ethical issue in the scenario. The patient Mr. J was 72 years old with mild dementia. In the case of Mr. J, there is no indication that he was combative hence the need for restraints. Therefore, there should be an audit of the documentation of Mr. J care to determine if there was a need for the use of restraints. The ethics committee analyzing the documentation should also determine what caused the pressure ulcer that was on Mr. J lower back because in the hospital setting pressure ulcer is supposed to be prevented. If any of the necessary care methods was not administered to the patient during the period of restraints, as the nursing supervisor, I would refer the nurse to the ethics committee (Doran & Almost, 2003). Consequently, I would organize a work training session that would be meant to refresh the nurses' knowledge on caring for patients with restraints and how to prevent pressure ulcers in the healthcare facility.


Mr. J case had several ethical dilemmas that mainly resulted from the nurses' procedure. The knowledge and understanding of nursing-sensitive indicators could have prevented many of the issues available in this case. Therefore, the hospital needs to collect and utilize data from such scenario to keep it from occurring again in the future. Lastly, the nursing supervisor should be equipped with several tactics and knowledge that can be used to address and resolve many ethical incidences are presented in Mr. J scenario.


Doran, D., & Almost, J. (2003). Nursing sensitive outcomes: The state of the science. Jones & Bartlett Learning.

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