Understanding of Nursing Quality Indicators
Nursing quality indicators translate the framework and efficacy of nursing care for a patient. In context to the given scenario, Mr. J depicts various nursing quality indicators that stipulate deteriorating nursing care shown towards him. The presence of bed sores is a strong indicator that the patient should be mobilized every now and then by a Certified Nursing Assistant (CNA). Although it was only in its initial stages if left unattended could lead to severe erosions. Another indicator was the prevalence of restraint used for Mr. J in order to prevent fall incidence. This raises an argumentative point that nurses are supposed to provide direct patient care hence negating the use of restraints. But in Mr. J’s case, this indicator was the most prominent one. Since his eating preferences were completely ignored and informing the patient’s attendant about the nursing mistakes was considered unimportant, such ignorant behavior towards patient care could lead to other morbidities and mortality for the patient. Even after the attendant raised her voice at the ignorance of the nursing staff their benighted behavior lead to decreased patient satisfaction.
B. Advancing Quality Patient Care
Patient quality care could be improved by first recognizing the nursing quality indicators at the departmental level and then strategizing various methods to incorporate measures for enhancing patient quality care throughout the hospital. Strategies such as maintaining departmental dashboards that contain graphs, pie charts, or even tables to inform the staff where they lack and the areas that need improvement. If a department of a hospital maintains a low percentage of falls in their unit, they should display a checklist on the dashboard of their department. This checklist should be circulated in all the departments of the hospital so that they can evaluate themselves accordingly and decrease the number of falls as well. A decrease in the number of falls will ultimately improve patient care by decreasing comorbidities such as hip fracture and any disability. A monthly meeting could be held where the committee members would discuss the data collected throughout the month evaluating nursing quality indicators. The results should be compiled in the form of graphs or simple checklists compared, first locally, and then with other hospitals to identify any shortcomings and appreciate any progress.
C. Resolution of Ethical Issues
The ethical issue raised in the particular scenario is the ignorance of the religious eating beliefs of the patient. The physician, who happened to be Jewish himself, understood the ethical issue empathetically and responded to it accordingly(Gastmans & Milisen, 2006). In such cases of ethical breach, a senior staff member or a fellow colleague could help resolve the issue as he can understand the sensitivity of the matter and thus can take appropriate actions. This has been supported by average various research that an ethical issue is better solved by a person who is connected ethically with the victim. This creates a bond of understanding between them leading to a better outcome the matter. This person could either be a physician, as in the scenario, or any admin member, or any colleague.
References
Gastmans, C., & Milisen, K. (2006). Use of physical restraint in nursing homes: Clinical-ethical considerations. Journal of Medical Ethics, 32(3), 148–152. PubMed. https://doi.org/10.1136/jme.2005.012708
Staggs, V. S., Olds, D. M., Cramer, E., & Shorr, R. I. (2017). Nursing Skill Mix, Nurse Staffing Level, and Physical Restraint Use in US Hospitals: A Longitudinal Study. Journal of General Internal Medicine, 32(1), 35–41. https://doi.org/10.1007/s11606-016-3830-z
