Western Governor’s University
RTT1 Organization Systems and Quality Leadership
Dianne Roque
August 19, 2015

American Nurses Association (ANA) define nursing-sensitive outcome indicators as “ those that capture care or its outcome most affected by nursing care.” (AmericanSentinel.edu, 2011) These outcomes are improved if there is greater quantity in the structure of nursing care (example: adequate staff and educational attainment of staff) and/or the process of nursing care. (assessment, intervention) In the scenario, the nurses have not demonstrated recognition of those nurse-sensitive indicators. The nurse aid, has she been aware of the complications of pressure ulcer and that it is one of the outcome indicators determined by ANA, would not have put the patient back to bed laying on his back but instead to his side in order to prevent pressure to his sacral area which is already showing signs of early stage pressure ulcer. She would also communicate to the patient and family about the importance of turning frequently to prevent pressure ulcers. She or the nurse would have also explained the need for restraints and explain if other measures for safety has failed.

Another nurse-sensitive indicator that was missed in the scenario was patient satisfaction, particularly in this case, family satisfaction as well because the patient was unable to fully express his needs due to dementia and medications. The nurse should have communicated the incident of missed kosher meal directly to the patient and his family.

The issues may have been prevented if the nurses understood that these indicators are very important in building trust with patient and family which is directly associated in providing quality care.

The Center for Medicare and Medicaid Services have been very strict regarding policies involving hospital acquired incidents. Pressure ulcer that is