Nursing Sensitive Indicators
According to Cantlin, & Kronebusch (2019) Nursing Sensitive Indicators are elements of care directly affected by the nursing practice and utilized in measuring the quality of care, clinical performance and outcomes. They are divided into structural, outcome and process indicators. Structural indicators comprise the nursing staff supply, their education, skill levels, and certification (Cantlin & Kronebusch, 2019). These indicators evaluate the methods of nursing interventions and patient assessment. Lastly, the outcome indicators are focused on patient outcomes which are directly associated with the quality or quantity of nursing care (Cantlin & Kronebusch, 2019). Outcome indicators include things like pressure ulcers and falls, among others.
Chosen condition
Pressure ulcer is one of the most crucial healthcare conditions in the critical care facility of my organization. It is currently an organizational requirement that patients must undergo head to toe skin assessment carried out by two nurses within 24 hours of admission. A patient transferred to another flour should undergo a comprehensive assessment to identify and treat pressure ulcers before complication. In bedridden patients, distortions may result in the damage of tissues below the skin, thus affecting the blood supply. If not managed, pressure ulcers may exacerbate into life-threatening complications such as gangrene and sepsis. Whereas each hospitalized patient has increased chances of developing pressure ulcers, certain conditions predispose patients to higher chances of pressure ulcers. Patients with compromised skin tissues, impaired mobility, serious illness, neurological disorder, and poor posture have enhanced risk of pressure ulcers (Farquhar, 2019). In addition to that, patients with fragile skin, insufficient fluids, depleted nutrient levels, decreased circulation and intubation have increased risks of pressure ulcers. The hospital-acquired pressure can result in increased hospital length of stay, damaged skin, infections and chronic pain.
The chosen indicator is pressure ulcers. According to the American Nurses Association, Pressure ulcers is considered both a process and an outcome indicator. Hospital-acquired pressure ulcers is one of the most fundamental nursing-sensitive indicators that require comprehensive care intervention, to reduce the incidence, prevalence as well as associated impact.
Care Plan for Pressure Ulcers.
There are various evidence-based intervention to prevent as well as manage hospital-acquired pressure ulcers. In my organization, the prevention protocol integrates repositioning and turning of bedridden patients, wound consult, toileting care, comprehensive skin assessments, specialty bed and heel provision and completion of the Braden scale.
In my care plan, the primary desired outcome is that the individual patient receives high-quality care that manages the pressure ulcers and prevents further worsening. I would incorporate three fundamental nursing interventions in my care plan. The first intervention is a daily assessment of the patient upon admission to assess the risk factors for pressure ulcers. According to () the incidence of breakdown resulting in pressure ulcers is directly associated with the number of present risk factors. Use of the Braden pressure ulcers risk assessment tool enables the nurse to rate the patient’s risks for pressure ulcers. The tool consists of subscales such as, mobility, activity, nutrition, moisture, friction and sensory perception, which accurately rate the patient’s risks for pressure ulcers. For acute care, patients should always be assessed when admitted and after every 24 hours or sooner based if their health condition worsens. For long term care, patients should be assessed on admission and weekly. However, if the patient’s condition worsens, the assessments should be done earlier. Patients with pre-existing sores will be closely monitored. However, upon noticing the presence of red, bleachable areas, pictures will be taken using the hospital phone and pinned on an avatar for analysis.
Secondly repositioning and turning patients after every two hours will be conducted. This technique prevents pressure ulcers by redistributing pressure. Patients who require additional cushioning will be provided with assistive devices to improve comfort. This would result in the prevention of pressure ulcers and the promotion of positive healthcare outcomes.
The third intervention would entail an assessment of the patient’s nutritional status, including serum albumin levels, weight loss and current weight. According to () compromised nutrition resulting from poor dietary intake, malnutrition and undesired weight loss leads to impaired collagen synthesis, altered immune function and decreased tensile strength. This significantly increases the risks of developing pressure ulcers. It will, therefore be fundamental to ensure the patient takes a healthy diet. For severe malnutrition, it would be helpful to consult a dietician who can aid in developing a nutritional plan to restore health, reduce the risks of pressure ulcers and foster positive healthcare outcomes.
Conclusion
In conclusion, nurse-sensitive indicators are utilized in healthcare settings to monitor patient outcomes and quality of care continually. Most diseases and conditions may result in significant quality problems with unknown impacts. Without nursing-sensitive quality indicators, it is impossible to monitor quality indicators. The indicators create a basis for quality improvement, accountability, transparency and prioritization in the healthcare settings.
Cantlin, D., & Kronebusch, B. (2019). In Pursuit of Meaningful Nurse-Sensitive Indicators. AAACN Viewpoint, 41(4), 8-19. http://search.proquest.com/openview/26b2b300b4e386d62fab5f5482dbca8f/1?pq-origsite=gscholar&cbl=46506
Joseph, L., & Samson, R. (2016). Indicators of nursing quality: Quantifying effects of nursing care interventions. International Journal of Current Multidisciplinary Studies, 2(5), 254-258.