National initiatives driven by the American Nurses Association have determined nursing-sensitive.
National initiatives driven by the American Nurses Association have determined nursing-sensitive
outcome indicators that are intended to focus plans and programs to increase quality and safety in
patient care. The following outcomes are commonly used nursing-sensitive indicators:
• Complications such as urinary tract infections, pressure ulcers, hospital acquired pneumonia, and
DVT
• Patient falls
• Surgical patient complications, including infection, pulmonary failure, and metabolic derangement
• Length of patient hospital stay
• Restraint prevalence
• Incidence of failure to rescue, which could potentially result in increased morbidity or
mortality
• Patient satisfaction
• Nurse satisfaction and staffing
Scenario to analyz :
Patient is a 72-year-old retired rabbi with a diagnosis of mild dementia. admitted for treatment of
a fractured right hip after falling in his home. He has received pain medication and is drowsy, but
he answers simple questions appropriately. A week after he was admitted to the hospital, his
daughter, who lives eight hours away, came to visit and found him restrained in bed. While he was
slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he
could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to
remove the restraints and help her father to the bathroom. When the CNA was in the process of
helping him sit up in bed, his daughter noticed a red, depressed area over His lower spine, similar
to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to
worry about. It will go away as soon as he gets up.” The CNA helped Him to the bathroom and then
returned him to bed where she had him lie on his back so she could reapply the restraints. The
diet order for Him was “regular, kosher, chopped meat.” The day after his daughter arrived, He was
alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and
observed that He had eaten approximately 75% of the meal. The meal served was labeled, “regular,
chopped meat.” The tray contained the remains of a chopped pork cutlet. The nurse notified the
supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then notified
the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had
happened. When the patient’s daughter visited later that night, she was not told of the incident.
The next night, the daughter was present at suppertime when a dietary worker delivered the tray.
The worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The
daughter asked what had happened and was told that there had been “a mix up in the order.” The
daughter then asked the nurse about the incident. The nurse, while confirming the incident, told
the daughter, “Half a pork cutlet never killed anyone.” The daughter then called the physician,
who called the hospital administrator. The physician, who is also Jewish, told the administrator
that he has had several complaints over the past six months from his hospitalized Jewish patients
who felt that their dietary requests were not taken seriously by the hospital employees. The
hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish
members usually receive care from a Jewish hospital 20 miles away in a larger city.
PAPER 2-3 pages body
Analyze the Above scenario by doing the following:
Part A. Discuss how an understanding of nursing-sensitive indicators could assist the nurses in
this case in identifying issues that may interfere with patient care.
Part B. Analyze how hospital data on specific nursing-sensitive indicators (such as incidence of
pressure ulcers and prevalence of restraints) could advance quality patient care throughout the
hospital.
Part C. Analyze the specific system resources, referrals, or colleagues the nursing shift
supervisor, could use to resolve the ethical issue in this scenario.
Part D. When you use sources to support ideas and elements in a paper or project, provide
acknowledgement of source information for any content that is quoted, paraphrased or summarized.
Acknowledgement of source information includes in-text citation noting specifically where in the
submission the source is used and a corresponding reference, which includes:
• Author
• Date
• Title
• Location of information (e.g., publisher, journal, or website URL)
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