Nursing Quality Indicators
Nursing quality indicators (NQIs) are used to assist medical practitioners in maintaining quality in their daily practices. This means that the patients' needs are fully satisfied, ensuring their safety and well-being at the highest quality level of care available. Despite the fact that all healthcare personnel are required to deliver safe and quality care, nurses are closely related to patient safety and quality care results (Murray, 2017).
Identification of Issues
Knowing the nursing quality indicators ensures that each patient's care is tailored to their specific needs. This is not fully realized in the instance of Mr. J. It is clear that many indications do not match. This patient has dementia, and there is no history of self-harm, and neither is he violent to others. As such, there is no reason as to have him in restraints in the first place. The caregivers seem oblivious to the indicators of restraint prevalence.
Importance of Patient Involvement
With the knowledge of nursing quality indicators, the caregivers would have been able to identify the issues that Mr. J was undergoing. These interferences to his wellbeing and comfort resulted in lack of patient satisfaction. When coming up with his plan of care, they do not base it on evidence; neither do they involve the family in planning his care. The nurse-patient relationship has changed over years as nurses no longer make all the decisions. They instead involve the patient and their families in the plan of care, (Murray, 2017). To avoid patient falls due to his drowsy state, the caregivers decide to use restraints which cause him more harm than good. It is evident when he develops a pressure ulcer, another NQI. Mr. J is responsive and can respond to simple questions when asked. He can recognize his daughter when she visits him. It indicates had he been offered an alternative, for example, a bed alarm; he would have been able to use it.
Advancing Quality Patient Care
The hospital should keep data of the NQI’S and analyze them often to help them identify the course of action taken. The indicators allow the staff to examine the value and patient aftermaths of the care given to patients by nurses. Many hospitals are evaluating their protocols related to these signs, to ensure the use of the statistics in evidence-based practice, (Kim and Mallory, 2013). This evidence can be used to assess the nursing practices and steps taken and how the implemented variations influence the outcome of patients in the whole hospital. Use of these measures can easily avoid potential issues. In Mr. J's case, had the hospital identified restraint prevalence to be high, they would have avoided putting him in restraints and instead focused on better countermeasures. These include round checking at least hourly by the nurse, active listening, family visit or staying with the patient among others.
Pressure Ulcers and Staffing Issues
Another indicator overlooked by the caregiver is the pressure ulcers. Mr. J develops this as a result of the restraints. The nurse is however quick to dismiss it as a non-issue which is not the case. Had they taken the initiative to turn him every two hours, these would be avoided. The hospital should analyze its data and see how many cases of pressure ulcers are reported to identify what the reasons are. For a healthcare organization to achieve its many essential goals, there is need to employ individuals who are capable of delivering quality health services, (Healey and Marchese, 2013). It could be that there is understaffing resulting in caregivers lacking satisfaction. The nurses would also lead to these measures if they feel overworked and by so doing it would lessen their workload. When the staff is dissatisfied then achieving patients satisfaction becomes a problem. For the hospital to realize its full potential, the NQI'S have to be fully understood.
Resolution of Ethical Issues
A patient's welfare is the priority of any given hospital. The healthcare reforms aim at creating opportunities for a healthcare system, (Healey and Marchese, 2012). When moral problems arise, they should be handled with utmost respect and care to avoid further complications. Mr. J has persevered a lot in the hands of the caregivers. As the nurse shift supervisor, it is crucial that all the involved parties are made aware of their mistake. It is essential to evaluate the structure of the system, its competence regarding experience as well as educational background. There are various issues and colleagues that as the supervisor I would need to address.
Addressing Issues and Educating Staff
First, I would seek an audience with the admitting physician to help understand why Mr. J is in restraints which serve as a last alternative on patients who have shown signs of causing harm to themselves or others. The next person would be the certified nursing assistant who dismisses a case of pressure ulcers as "nothing that would disappear when he wakes up." I would seek to understand why she would do this and establish whether it's a case of negligence or lack of knowledge. I would involve the hospital administrators to come up with an informative session for all the hospital staff, inclusive of the dietician about the need to respect the cultural needs of a patient, this in regards to the numerous complaints about the Jewish patients. In so doing I also would talk with the dietician involved, the nurse on duty as well as the kitchen supervisor regarding the pork issue.
As much as these entire people are made accountable, I would evaluate the system to see the loopholes towards achieving patient satisfaction. Leadership is one of the most critical functions of managers, but not all managers are capable of performing this task, (Healey and Marchese, 2012). A simple thing as reassigning some staff other duties would be the key to solving these arising issues. I would strive to create an environment that is conducive, where the nurses are free to air their grievances without fear of victimization. It would reduce the number of unreported cases like this one. The need to educate the hospital caregivers on the nursing indicators would have me organize for educational sessions to deal with such matters.
Conclusion
In conclusion, the hospital has to ensure that its patients receive the optimal care possible. Observing the nursing quality indicators is a simple but sure way of doing so.
References
Murray, E., (2017); Nursing Leadership and Management: For Patient Safety and Quality Care. Philadelphia, F.A Davis Company.
Kim, M.J., Mallory, C., (2013); Statistics for Evidence-Based Practice in Nursing. Burlington, Jones and Barlett Learning.
Healey, B.J., Marchese, M.C., (2012); Foundations of Health Care Management: Principles and Methods. San Francisco, John Wiley and Sons Inc.
