...was a pilot program designed to evaluate the links between nurse staffing and quality care (Montalvo, 2007). The program outcome was a set of nursing-sensitive indicators used to evaluate quality care for patients in the acute setting and the start of the National Database of Nursing Quality Indicators (NDNQI). The NDNQI is a database which collects the information from the survey collected from the acute care settings. The information compiled is used to develop nursing care and influence the quality of care given to patients (Montalvo, 2007). “Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes” (Montalvo, 2007, para. 3). Knowing the nursing-sensitive indicators could have helped Mr. J in multiple ways. Pressure ulcer prevalence is one of the indicators that could have helped the situation. If the CNA who was helping Mr. J to the restroom had more training and knowledge about pressure sores they would have been able to identify that Mr. J had some skin breakdown. The skin breakdown happens when a person is in one position for too long. Instead the CNA disregarded the signs of a stage 1 pressure area and put Mr. J back to bed in the same position instead of making sure he was in a different position. Restraint prevalence is also one of the nursing-sensitive indicators. In this case, the restraint was used incorrectly most likely due to lack of knowledge about the correct use of...
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...Organizational Systems and Quality Leadership Organizational Systems and Quality Leadership Task 1 A. Nursing Sensitive Indicators Nurses are integral key players in multidisciplinary teams caring for patients in complex healthcare systems. Hospitals, a primary care delivery portal within the health system, are inundated with patients requiring higher acuity care. Nurses must be prepared to recognize patients’ health care needs and provide quality patient care outcomes. The knowledge of nursing sensitive indicators can be helpful in providing the care which meets quality standards. Nursing sensitive indicators rely on evidence-based practice. The American Nurses Association created a repository for implementing, developing, and storing nursing sensitive indicators in the National Database of Nursing Quality Indicators, or NDNQI. The nursing sensitive indicators are a set of standardized performance measures intended to help hospitals assess the extent to which nursing interventions have an impact on patient safety, quality, and the professional work environment (Erickson, J. 2011). Nurses directly impact these measures and when evidence-based practices are adopted, patient care improves as shown in historical outcomes data. In the scenario of Mr. J there were multiple failures to recognize and use nursing procedural sensitive measures to improve his safety, quality of care, and patient satisfaction. Although Mr. J had mild dementia, he was appropriately responsive...
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...Task 1 Nursing-sensitive Indicators Nursing- sensitive indicators are defined as those outcomes that improve in the presence of greater quantity(higher staffing ratios) or quality(educational levels and competence of nursing staff) of nursing care (www.nursingworld.org). These nursing-sensitive measures help healthcare organizations to analyze the quality and quantity of nursing care services. (www.americansentinel.edu )Nursing sensitive-indicators (NSIs) are characterized by measures that are in the realm of nurses to improve and control. According to the website www.nursingworld.org , in 1998, the National Database of Nursing Quality Indicators was established by the ANA so that nurses would have a national benchmark to reach they can compare the outcomes. This has given the profession of nursing a solid core of benchmark capital nursing sensitive indicators that are totally nursing care dependent. This database provides benchmark performance with which the individual healthcare institution can compare its performance to similar institutions across the nation. These nursing sensitive indicators result in patient outcomes that are influenced by nursing care decisions and actions. Research has indicated that patient outcomes improve, complications and mortality are reduced, costs can be reduced, and patient and professional nurse satisfaction can be enhanced with strong performance on nursing-sensitive indicators. These patient outcomes may not because the nursing but is associated...
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...Technology Western Governors University Adam Culbertson A. New Information Management System Implementation of a computer system to replace paper documentation would require the involvement of an interdisciplinary team. This team would be comprised of several members, each with a specific job. The first member selected would be a Clinical Nurse Informaticist. This team member would be charged with giving valuable input on the software needed for nurses to properly care for and chart on their patients. With the knowledge of nursing practice and informatics, this team member would very valuable in bringing the two together in the most efficient way possible. The next team member would also be from the IT department. A Director of Clinical Informatics would be chosen for this project. The Director of Clinical Informatics play a vital role in the project because of the knowledge of current hospital technology, upgrades that may be needed, software that is available, and regulations for patient privacy. A Chief Nursing Information team member would in charge of researching what each department needs in a software system. With each unit being different in charting needs and the flow of the unit, this team member would be very important and work closely with the Clinical Nurse Informaticist. These two team members would work closely with nursing staff to ensure everyone becomes competent with the system once it is in place. Just as nurses need a representative, the Doctors would also...
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...preventable through the simple action of hand hygiene. Hand hygiene is a vital part of the hospital system to ensure the continuum of health. The number of professional health care staff who is not abiding by the governing policies on hand hygiene is alarming. It is an issue that is particularly relevant to nurses as they are in constant contact with patients, more so than any other health care professional. This paper shall address the topic of hospital acquired infections in relation to the lack of hand washing and poor hand hygiene. It shall hence be explored the reason behind the issues existence. Background Modern infection control is grounded in the work of Ignaz Semelweis who, in the late 1840’s demonstrated the importance of hand hygiene for controlling transmission of infection (Pittet, Allegrazi, & Boyce, 2009) and reduced mortality rate related to hospital acquired infections (Mortell, 2012). Hand hygiene has become an integral part of our culture. Hand washing is taught at every level of school, advocated in the workplace, and emphasized during nursing, medical, and paramedic training programs. The primary objective of hand hygiene recommendations has always been to reduce pathogen transmission and hospital acquired infections which, in turn, should reduce patient morbidity and mortality (Mortell, 2012). Hand Hygiene has been recognized and practiced for more than a century and is supported by evidence. According to NHS and Centers for Disease Control and Prevention...
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...survey/test outcomes. One of the tests was the Myers-Briggs type indicator (MBTI); this test defined my personality type as an ENFJ (extraversion, intuition, feeling, judgment). I identify very much with the description of ENFJ. When taking the Self-Assessment Tests: The Grossman & Valiga Leadership Characteristics and Skills Assessment I was assessed as having good perception of a good leader, but only moderate perceived leadership ability. This was confirmed when I took the Davis Plus assessment my score of 44 “suggests I am using key leadership skills well—but I ask a co-worker or partner for his or her opinions, to be more certain. These assessments are impressively accurate in my opinion. I believe that knowledge is power. By understanding my personality type, leadership, and learning style, I have clearly gained some insight into my strengths and weaknesses. It opens opportunities for growth where I am weak and builds confidence in my strengths. Finding out that the MBTI test defined my personality type, as an ENFJ was very interesting. It is easy to digest such a lovely representation of my personality type when described with such palatable adjectives as: giving, people oriented, natural teacher, straightforward, honest, charming, warm, gracious, creative, selfless, happy, organized and kind. The description of the weaker side of being an ENFJ paints less attractive portrait with words like extremely sensitive to criticism, tendency to worry excessively, feels guilty...
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...Change Initiative Paper Cynthia D. Sanchez Grand Canyon University: LDR 615 November 4, 2014 Change Initiative Paper It has been said that the only thing that is constant in an organization is change. Our global economy has escalated the opportunities for growth at an exponential rate. But, for an organization to remain relevant and competitive in today’s marketplace, they must be willing to change. How do real-work organizations implement and sustain successful change? Two important patterns have been identified for success: “first, useful change tends to be associated with a multi-step process that creates power and motivation sufficient to overwhelm all the sources on inertia”, and second, this process is never employed effectively unless it is driven by high quality leadership” (Kotter, 1996, p. 20-21). Strategic planning, which should include identifying the change model to be followed, outlining the role of leadership, and planning for how to overcome potential barriers and sustain the change, all play a vital role in a successful change initiative. The purpose of this paper is to first identify a specific organization that could benefit from a change initiative that would improve their effectiveness, and then outline strategies and processes that would influence the adoption of the change initiative. The Need for Change The Army Nurse Corps has a program geared toward new graduate Registered Nurses (RNs) that are entering the military health care system called...
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...falls during inpatient hospitalization has become a top safety issue for long term care facilities and hospitals. Inpatient falls have a major impact of length of stay (LOS) especially when fall-related injuries require additional tests (head trauma), surgical interventions (hip fractures), and therapy (physical and rehabilitation therapy). Reducing falls among inpatient (hospitalized patients) is a growing patient safety concern for health care organization. Today, health care organizations are being more proactive in reviewing, evaluating and implementing fall prevention program and strategies. Collecting and analyzing data are vital components for measuring, monitoring, and revising quality and improvement programs. The purpose of this paper is to analyze the case example Falls and examine the data collection methods used to monitor and revise quality improvement programs. Measures to Monitor and Revise Quality Program Implementation According to the Center for Disease Control and Prevention (CDC, 2010), falls are the leading cause of injury among individuals 65 years and older. Falls can result in severe injuries such as hip fractures and head trauma. The economic impact for medically treating and managing fall and fall-related injuries are astronomical. In 200, the U. S health care system spent over $23 billion dollars on falls and fall related injuries and the cost is expected to increase to over $44 billion dollars by the year 2025. Because of these two statistical factors...
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...is a basic human right; optimal health is a well-balanced structure of emotional, physical, spiritual, psychological, intellectual, and social well-being. The purpose of health promotion in nursing is to increase health knowledge that will in turn positively influence health behaviors of individuals and communities (Foster, 2012). Roughly 36% of the U.S. population is made up of various ethnic or racial minorities. Of that 36%, 4.8% were Asian Americans. According to the Office of Management and Budget, “Asians” consist of people that originate from the Far East, Southeast Asia, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan Thailand, Vietnam, or the Philippine Islands (CDC, 2014). These 14.7 million people are dispersed throughout the country, with Hawaii having the largest concentration (57%) of the total Asian population (CDC, 2014). The CDC (2014) states that minority groups “experience a disproportionate burden of preventable disease, death, and disability compared with non-minorities.” This paper will concentrate on health promotion among the Asian American population, compare and contrast the health status of this minority group to the national average, and describe suggested health promotion prevention techniques tailored to the specific needs presented in this paper. Comparison of Asian Americans to the National Average According to the 2010 Census, the fastest growing population than...
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...pharmacological and non-pharmacological treatments; 2. changes in consumer demands and expectations; 3. fiscal and resource constraints; 4. changes in societal demographics in particular the ageing of society; 5. an increasing burden of chronic disease; 6. documentation of limitations in traditional health care delivery; 7. an increasing emphasis on transparency and accountability, 8. evidence based practice (EBP) and clinical governance structures; and 9. the increasing cultural diversity of the community. These challenges provoke discussion of the necessity of developing services around a model of care. What do we mean by a model of care? Ambiguity exists in the literature, with the terms, model of care, nursing model, philosophy, paradigm, framework and theory often used interchangeably, despite referring to diverse, yet parallel concepts (Tierney 1998). In their recent review of the literature, the Queensland Government (Australia) reported that they found no consistent definition of ‘model of care’ (Queensland Health 2000). They concluded that a model of care is a multidimensional concept that defines the way in which health care services are delivered (Queensland Health 2000). More specifically, Davidson and Elliott (2001) described a model of care as a conceptual tool that is ‘a standard or example for imitation or comparison, combining concepts, belief and intent that are related in some way’ (p. 121). They consider it to be critical...
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...Improvement Report Cynthia Leonard, BSN, RN HCS/588 June 4, 2012 Darlene M. Cantu, RNC-NIC, C-EFM, MSN Quality Improvement report Quality measures and quality improvements are the focus of most health care organization today. Quality has many meanings and consumers, health care organization, regulatory agencies, and professionals have different view of the meaning of quality. Quality has advanced from the ability to give good care to the need to ensure that patient’s expectations are met. Quality in health care encompasses professional quality requirements and patients expectations. This paper will highlight the concepts of QI, including definitions of quality, along with patients, and professional roles in quality improvement. The paper will mention why quality management is requirement in the health care industry and how to monitor quality. The paper will also highlight the roles of accrediting and regulatory organization along with identifying helpful resources for organizations that affect QI. Foundational Frameworks of QI Industrial models have influenced how health care organization approaches quality improvement. Leaders, such as Armand Feigenbaum, who was the originator of total quality control, offered health care organization with “…a system that integrates quality development, quality improvement, and quality maintenance” (Ransom, Joshi, Nash, & Ransom, 2008, p. 67). Kaoru Ishikawa contributed to the quality movement by the introduction...
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...nation of a predominantly white population to an ever growing culturally diverse population. Many of these cultural groups are documented minority groups, which face many problems with accessing and receiving adequate health care. Looking at the 2010 U.S. Census, close to 36 percent of the population was a part of an ethnic or racial minority group. These minority groups include American Native Indian, African American, American Asian, Pacific Islander, and Latino or Hispanic. Some minority groups have increased risk factors and experience a greater and disproportionate burden of disease, preventable illnesses and disability and morbidity rates compared with non-minority groups ("Centers for Disease Control and Prevention," 2014). In this paper, the author will compare and contrast the health status for the minority group of Hispanic/ Latinos to the national average, describe how health promotion is defined and what barriers and disparities exist for this minority population, and will describe three levels of health promotion prevention and which would be optimal for teaching the Hispanic/Latino people. The Current Health Status of Hispanics The Hispanic /Latino minority group is our nation’s largest ethnic or race minority. According to U.S Census Bureau’s studies, as of July 1, 2013, there are approximately 54 million Hispanics living in the United States which represent 17 percent of the nation’s total population. The estimated Hispanic population...
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...of Nurses LITERATURE REVIEW INTRODUCTION A literature review is a critical appraisal of researches that provides a comprehensive and up to date knowledge on a specific topic (Coughlan, Ryan and Cronin 2013). The purpose of literature review in nursing includes evaluating current practice and making recommendations for policy development and change. Thus, the purpose of this literature review is to establish the current perspectives of patients, family and nurses on the factors that improve dignity in the end of life. Resultantly, this literature review will explore the role of nurses’ based on the findings of the perspectives that patients, family and health professionals have concerning the issue of dignity in the end of life care. In that regard, the paper follows a systematic approach which involves an introduction that explains the concept of end of life and the types of end of life care available. The paper then proceeds to explore the concept of dignity as viewed from several perspectives through the use of literature on the models of dignity means of measuring dignity and the themes associated with this conception. Consequently, the factors that improve dignity are laid out and discussed at length. Eventually, the paper will achieve its secondary goal which is to determine and expound on the topic of the roles that a nurse plays in end of life care not only for the patient but also for their family. End of life care Before the discussion of the main topic of this...
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...BAMA Triage Improvement Plan Control Team Blue SYM 630, MOD 7 June 15, 2010 Introduction The control phase of DMAIC is critical to sustaining the gains achieved from the previous phases. Control plans help add discipline and accountability to goals of the project improvement. A comprehensive control plan allows there to be a documented guideline that can be easily followed to make sure that the improvements of a Six Sigma project are maintained. This paper will show the development of a robust control plan in terms of the four components including discipline, documentation, score keeping, and process management plan. Healthcare is a critical industry that can benefit from the Six Sigma mindset. Review of BAMA Broderson Army Medical Authority (BAMA) is a fictitious 425 bed Level One Trauma Center owned and operated by the United States Army. BAMA offers a wide range of critical treatment opportunities such as a world-class burn institute, traumatic brain injury institute, poly-trauma center and a center for the rehabilitation of amputees that is based on cutting edge technology. Because of this specialized capability, the majority of BAMA’s new patients come through on an emergent base. Six Sigma Issues The ER of any hospital is considered a high visibility department secondary to their emergent demographic. BAMA has approximately 40,000 visits to the emergency room (ER) each year. This can have the entire above-mentioned patient load in various states of repair...
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...Childhood Obesity In the Workplace Vulnerable populations are those at risk for poor physical, psychological, or social health. Anyone can be vulnerable at any given point in time as a result of life circumstances or response to illness or events (De Chesney, M., & Anderson, B. A., 2008). A vulnerable population recently identified and being a focus on in my workplace is childhood obesity. Several of this adolescent is presented to our hospital with an acute illness as well as obesity as a co-existing condition. This paper will be explaining the action plans, which nurses and or any other health care workers can help and educate these adolescent and their family on healthy life style during their hospital stay. Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing. Due to the rising prevalence of obesity in children and its many adverse health effects it is being recognized as a serious public health concern. The term overweight rather than obese is often used in children as it is less stigmatizing. The mixture of diet along with sedentary lifestyles is creating a generation of children who are facing adult health issues. Changing the trend in the rate of child obesity in America is not difficult as long as parents are willing to accept their responsibility for teaching their children healthy lifestyles (Mayo clinic 2011). There are various ways one can diagnose childhood obesity. As part of regular well-child care...
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