The nursing profession involves complex issues of maintaining and improving human life. The nurses must meet some standards of care to ensure that they offer quality care to the patients. Since different healthcare providers would define quality care differently, the American Nurses Association has set specific standards to facilitate quality of care. The standards also called the quality indicators, rely on Florence Nightingale’s ideology that claimed that environmental concerns determined the level of patient outcomes. This paper evaluates different quality indicators and their contribution to providing quality care to patients.
The American Nursing Association (ANA) was developed in the National Database of Nursing Quality Indicators (NDNQI) in 1998 to indicate the nursing reports on the impact of nursing operations at different levels. The NDNQI aims to develop a fast-growing strategy of acquiring knowledge to improve the nursing quality of care (Merkley et al., 2018). The strategy was effective and efficient in determining the quality of care since it is difficult for any healthcare professional to measure and evaluate their caring practices. Therefore, the quality indicators determine whether particular practiced nursing practices affect the patient’s outcomes by providing positive or negative effects. These sensitive indicators include patients’ falls, staff mix, patient’s satisfaction, nurse job satisfaction, rates of nosocomial infections, pressure ulcers, and nursing- hours per patient day (Evangelou et al., 2018). In Mr. J’s case, evaluating this indicator would ensure that he receives quality care.
Nurses need to evaluate the possibility of patient falls. ANA indicators of quality care indicate the patients fall with and without injuries (Naik et al., 2020). Therefore, nurses should evaluate the patient’s condition to know whether there is any factor that would cause patient falls. In this case, the patients ensured that Mr. J would not fall when turning on the bed; hence they kept him restrained. Besides, they ensured that he would relieve himself with support from a family member or by the help of the caregivers. Evaluating patient satisfaction is another essential indicator that the nurses should have considered ensuring quality patient care. Patients’ satisfaction involves their satisfaction with strategies used for pain management, their satisfaction with nursing care, their contentment with the information provided on their medication, and overall satisfaction (Merkley et al., 2018). In Mr. J’s case, the nurses and other hospital workers did not consider this indicator since the patient was not satisfied with the services in the healthcare sector.
First, Mr. J. was not satisfied with the pain management strategies offered by the hospital since he was left unturned for a very long time, such that he developed bruises for staying in the same place for a long time. Besides, the nurses failed to consider the consequences of restraining him due to his broken rib and assumed other challenges that may arise due to the restriction. The patient was also unsatisfied with the nursing care since the nurses left him unattended for a long time and ignored other problems that arose from the length restrictions. For instance, he had to wait until his daughter came to visit him to be unrestricted to visit the toilet. If the nurses had considered this indicator, they would have planned for frequent taking him to the toilet or changing his sleeping position. Besides, they would have used more appropriate care tools such as the catheter to ensure that the patient relieved himself more comfortably. Mr. J is also unsatisfied with the overall care given by the healthcare workers since they do not honor his dietary request. Being a Jewish Rabbi, Mr. J does not consume pork. However, the hospital’s dietary worker does not respect his lifestyle and instead insists that “half a pork cutlet never killed anyone.” The ignorance leaves the patient and his daughter angry hence contacting the hospital administration to register their disappointments.
The nurses should also have considered hospital-acquired nosocomial infections. In this case, the nurses failed to consider this indicator hence making Mr. J have bruises due to the prolonged restriction. Besides, he was subjected to acquiring urinary tract infections and stomach-related problems due to prolonged restriction of digestion wastes. The nursing hours per patient day is also a vital indicator of quality care in nursing. The indicator considers the nurse-to-patient ratios, which is the number of patients a nurse should attend to daily (MacDonald et al., 2018). This consideration is important since it ensures that the patient’s vital diagnoses are taken in time to ensure that patients are satisfied with all aspects of care in the healthcare facility. In Mr. J’s case, the nurses failed to consider this indicator, leaving them unattended for a long time and getting bruises.
Hospital data on specific nursing- quality indicators helps improve the quality of care between patients in different ways. The data on these indicators is essential in improving the quality of care given in a particular healthcare sector by providing sufficient information on the areas that require improvement to improve patient outcomes (Koch et al., 2020). The data helps the healthcare management design more effective interventions to improve the caring process. For instance, data on the level of satisfaction of patients with broken limbs would help determine other conditions with a particular intervention on the patient. For instance, if the nurses attending to Mr. J had sufficient data on the consequences of restricting the patient for a long time would make them develop bruises and other complications such as back and joint pains. Hence, they would have ensured that the patient is allocated more caring time to change his sleeping position and take him to the toilet. Data on patients’ satisfaction with nursing care for patients with similar problems as Mr. J would also help the nurses improve the quality of care by helping them determine the most appropriate methods of care they would require. For instance, they would know that instead of leaving him to struggle with visiting the toilet, they should have used the catheter and fed him using glucose to avoid going for long calls when he cannot move.
Moreover, data on the number of nurses per patient per day is essential in determining when patients should be attended. In this case, the nurses would know what they require to offer effective care to the patients and the time needed to check on the well-being of the patients. Since patients in a healthcare facility have different illnesses and the severity also differ, the nurses should allocate different time to different patients. For instance, if Mr. was in the same ward with patients who had broken limbs, it was inappropriate to allocate them equal time. The nurses should have allocated Mr. J more hours than other patients who could change their sleeping positions and take themselves to the toilet.
In conclusion, the quality indicators in nursing ensure that they offer quality care to the patients. These sensitive quality indicators include patients’ falls, staff mix, patient’s satisfaction, nurse’s job satisfaction, rates of nosocomial infections, pressure ulcers, and nursing- hours per patient day. Hospital data on specific nursing- quality indicators helps improve the quality of care between patients in different ways. The data on these indicators is essential in improving the quality of care given in a particular healthcare sector by providing sufficient information on the areas that require improvement to improve patient outcomes.
References
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Merkley, J., Amaral, N., Sinno, M., Jivraj, T., Mundle, W., & Jeffs, L. (2018). Developing a Nursing Scorecard Using the National Database of Nursing Quality Indicators®: A Canadian Hospital’s Experience. Nursing Leadership (Toronto, Ont.), 31(4), 82-91. https://doi.org/10.12927/cjnl.2019.25752
Naik, S., Voong, S., Bamford, M., Smith, K., Joyce, A., & Grinspun, D. (2020). Using a data quality index, the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database. Journal of the American Medical Informatics Association, 27(5), 776-782. https://doi.org/10.1016/j.aucc.2016.04.003
Evangelou, E., Lambrinou, E., Kouta, C., & Middleton, N. (2018). An integrative review identifies validated nursing quality indicators for the intensive care unit. Connect: The World of Critical Care Nursing, 12(2), 28-39. DOI: 10.1891/1748-6254.12.2.28
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