A) There are several issues in the case of Mr. J that need to be examined. Using nurse sensitive indicators “reflect patient outcomes that are determined to be nursingsensitive because they depend on the quality or quantity of nursing care” (American
Sentinel University, 2011). Mr. J. was not receiving acceptable care, because his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. This skin condition is the first stage of a developing pressure ulcer.
a. Nurses should be aware that a patient with limited mobility is at risk for skin breakdown, and pressure ulcers. Anyone with limited mobility should be assisted to change positions by the care providers on a regular schedule to help circulation and prevent skin breakdown.
b. Providers should also consider that the patient is 72, and has fragile skin due to aging skin. This also places the patient at further risk for pressure ulcers.
c. The patient is also on restraints, which limits mobility even further. While restraints can help confused patients from falling, they can also cause skin damage. Care providers should continually access the need for using restraints, and remove them as soon as possible.
B) Using hospital data on nursing sensitive indicators could advance quality care throughout the hospital. In this case, the hospital should examine the incidence of pressure ulcers, the use of restraints, and dietary requests.
a. When examining the pressure ulcers, the hospital should consider what type of patients are acquiring them? Does it happen on a specific unit more than others?
If so, what are the staffing ratios on that unit? Are they implementing pressure ulcer prevention protocol? If not, the staff needs to be educated about pressure ulcer prevention and what patient populations are at high risk for skin break down and