Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care.
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
Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was 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 Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J 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 Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J�s 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 Mr. J 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 Mr. J was �regular, kosher, chopped meat.� The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J 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.
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