ASSIGNMENT HELP | Complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT

INTRODUCTION
National initiatives driven by the American Nurses Association have determined nursing-quality 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-quality indicators:

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• 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

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SCENARIO
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.

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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.

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 the tray was delivered by a dietary worker. 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.

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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.

REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Analyze the scenario (suggested length of 2–3 pages) by doing the following:

A. Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

B. Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.

C. Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario.

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D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

E. Demonstrate professional communication in the content and presentation of your submission.

MODEL ANSWER

A. Understanding the Quality Indicators in Nursing
The nursing practice sensitive indicators refer to those that influence the nurse practitioners and reflect three fundamental aspects: process, outcomes, and | PLACE YOUR ORDER NOW AT writtask.com | facets, according to Passmore (2018), are the satisfaction of patients with nursing and general care, pressure ulcers, the nurses’ work satisfaction, nosocomial infection rates, cumulative nursing care hours per patient each day, and staffing ratios for LPNs, unlicensed staff, and | PLACE YOUR ORDER NOW AT writtask.com | case scenario, there were several preventable issues of | PLACE YOUR ORDER NOW AT writtask.com | area concerned Mr. J’s pressure ulcer that his daughter recognized as a red depressed region on Mr. J’s lower spine. Mr. J was an older patient of 72 years with dementia, recuperating from a broken | PLACE YOUR ORDER NOW AT writtask.com | with pain prescriptions, dementia may confuse and lead to the nurse restraining the patient restricting mobility and repositioning for long | PLACE YOUR ORDER NOW AT writtask.com | mobility and repositioning of the patient leads to pressure ulcers (MacDonald et al., 2018).
The other aspect concerned the patient’s meal, which was supposed to be “regular, kosher, chopped meat,” due to Mr. J’s Jewish | PLACE YOUR ORDER NOW AT writtask.com | nurse did not follow through with the patient’s diet serving chopped pork. The nurse neglected to follow the patient’s meal order, and it was not the first time, and the supervisor was aware of the | PLACE YOUR ORDER NOW AT writtask.com | reported other complaints stating that the hospital staff did not take | PLACE YOUR ORDER NOW AT writtask.com | indicators should set protocols to ensure that nurses deliver high-quality care to their patients. As such, the nurse and hospital staff’s conduct did little to improve Mr. J’s quality of | PLACE YOUR ORDER NOW AT writtask.com | the pressure ulcer symptoms saying they would disappear as soon as the patient got up. On the other hand, the supervisor knew of the mix-up of the patient’s meal order and dismissed it instead of addressing the issue. Patient satisfaction and quality of care should be the primary concerns for nurses as per the nursing quality indicators