Nursing-sensitive indicators reflect the structure, process and outcomes of nursing care. These are measurable indicators of the quality of care provided to patients. Quality and/or quantity of nursing care can and does affect patient outcomes and the understanding of these measurements can assist in the planning and implementation of nursing care so that appropriate, quality health care with positive outcomes can be achieved. Poor performance on these indicators means not only is the quality of the care provided not good enough, but also they lead to longer, much more expensive hospital stays with poorer outcomes for the patient. Use of restraints for safety is, unfortunately, sometimes necessary. Options to explore first should be: Is there a family member that can come and sit with the patient to keep calm and safe? Does the hospital itself provide sitters in the room for safety? Can the patient be moved to a room closer to the nurse’s station so they can be monitored by staff? Does the hospital have a “niche” cart to keep their confused patients busy? When restraints are used, it is of utmost importance to release the restraints every hour for range of motion exercise and to turn the patient hourly to prevent pressure ulcer and DVT occurrence. More importantly, if a pressure ulcer is starting to form, it must be documented per institution protocol and the patient must be turned and kept off the site so the pressure ulcer does not progress. Although not addressed in this scenario, is the head of bed elevated? Aspiration and hospital acquired pneumonia are also nurse sensitive indicators that can lengthen a hospital stay and greatly increase costs-both to the patient as well as the hospital.
As health care moves more and more to electronics records, reports and information gleaned from patient’s records regarding nursing sensitive indicators can