Quality Indicators for a Nurse Practitioner

Understanding of Nursing Quality Indicators

Quality is a comprehensive term that incorporates a variety of facets of nursing care. The American Nurses Association identified nursing quality indicators in effort to ensure quality patient care. The National Database of Nursing Quality Indicators is a deliberate databank of unit-specific quality markers that are immediately linked to nursing care. This set of data reflects the connection among staffing ratios, direct patient care, and result of quality. If the nursing staff in this particular incident had been more educated on indicators of nursing quality, then they would have sustained changes that would have resulted in improved quality.

There are many things in this incident that I find alarming. The first thing I noted was the improper use of restraints. Improper use of restraints increases the risk of pressure injury which was also noted on the patient and which the CNA ignored after she was notified. The CNA is not qualified to do skin assessments and she did not engage in proper notification of the RN. Also noted was that the patient received the incorrect meal and the supervisor seemed to try and cover it up by telling the RN to keep it quiet.

By pinpointing nursing quality indicators, the hospital would have obtained information on vital procedures to assist them in identifying potential problem areas such as the use of restraints and pressure ulcer prevention. This would help them facilitate for quality improvement in these areas.

Advancing Quality Patient Care

Nursing quality indicators permit nurses and leadership to examine and evaluate nursing performance relative to patient outcomes. Establishing ways to examine these trends can help to identify ways of averting these things from happening. The hospital can utilize the data to determine organizational objectives for improvement at the unit level, and mark progress in improving patient care and the work atmosphere. The hospital would be adept to quantitatively pinpoint the extent of current challenges by assembling data regarding the adverse effects of restraints and hospital acquired pressure ulcers. Information includes specific methods to prevent pressure ulcers as well as patients who are at highest risk of developing ulcers. Information will also be provided on individuals at highest risk of adverse effects of restraint use as well as what types of adverse effects can occur.

Statistics from the nursing-quality indicators will act as a measuring scale should the hospital decide to integrate an improvement proposal. If plans for improvement were effective, the hospital would display shorter hospital stays, increased satisfaction rates, improved patient outcomes, and increased proceeds by reducing the costs of treating adverse reactions during hospitalization.

Resolution of Ethical Issues

As with many jobs in healthcare, there are many resources that can be utilized in order to solve ethical dilemmas. Healthcare professionals are not required to be able to solve complicated ethical problems alone. Frequently, other sources are needed to understand the full complexity of an ethical dilemma. Discovering ways to effectively deal with ethical conflicts is crucial not only to nursing staff, but also to the hospital in effort to improve outcomes. Resources that can be utilized include The ANA Code of Ethics. Nurses should be acquainted with the code and utilize it daily as it presents a structure for practice. As a manager, I think it is essential to include conduct consistent with the code of ethics into job descriptions and reflect that through annual performance reviews. This is essential when it comes to the scenario and fact that the wrong tray was given, and the supervisor asked the nurse to keep it quiet.

Another very important resource that should be utilized is our nurse educators. Our nurse educators play a vital role in healthcare. Offer ongoing education to all staff. Education is key and gives nurses the tools for making decisions. New member orientation and all education offered must incorporate ethics matter, including precise examples of application of theoretical principles to existing issues. It is evident that education was needed during this scenario as it appeared that there was improper use of restraints and the possible formation of a pressure ulcer.

An additional important resource is our assistant nurse manager. We need to establish a setting where nurses can communicate. This starts from the top and especially with our assistant nurse managers as they work closely with the staff on the unit. Having a workplace environment that stands behind its nurses in introducing ethical questions and inspiring them to address those concerns is important. As in the scenario, it is possible that the nurse assistant disregarded the fact the patient had a possible pressure ulcer and did not notify the nurse because communication was not up to par.

Lastly, we need to be more adept in collaborating with all staff. This includes collaborating with the dietary supervisor. We need to determine where the root of the problem lies so that we may develop a plan to resolve it and move forward. This is evident in the fact that the wrong tray was given and that there were several complaints over the past few months from patients who believed that their nutritional requests were not taken seriously by the hospital employees. 

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